Boulard G, Guérin J, Ducassou D, Sabathié M
Ann Fr Anesth Reanim. 1983;2(6):401-4. doi: 10.1016/s0750-7658(83)80057-4.
Cerebral oedema, present or potential, is a predominant medical complication of neurosurgery. Its physiopathology and treatment can be in part linked to adrenal activity (aldosterone and sodium balance; cortisol and hormone treatments). In 25 non-comatose patients presenting with a tumoral or vascular neurosurgical condition, plasma cortisol and aldosterone levels were measured by radioimmunoassay, always at the same time (07 h), before any investigations or treatment were carried out, the patient being at rest. Cortisol levels were increased in more than half the patients (n = 14; 44.11 +/- 3.4 micrograms X 100 ml-1; p less than 0.001); aldosterone levels were high in one third of the patients (n = 8; 304.29 +/- 57 micrograms X ml-1; p less than 0.001). 17 of these patients were studied according to the protocol of the synthetic ACTH test during the first four days of their receiving 1 mg X 24 h-1 synthetic ACTH. The expected therapeutic effect on cortisol was not obtained in all cases, and the stimulation of aldosterone release was important and prolonged.
脑水肿，无论是已存在的还是潜在的，都是神经外科手术的主要医学并发症。其病理生理学和治疗在一定程度上可能与肾上腺活动（醛固酮与钠平衡；皮质醇与激素治疗）有关。对25例患有肿瘤性或血管性神经外科疾病的非昏迷患者，在未进行任何检查或治疗、患者处于静息状态时，总是在同一时间（07时）通过放射免疫分析法测定血浆皮质醇和醛固酮水平。超过半数患者的皮质醇水平升高（n = 14；44.11±3.4微克×100毫升-1；p < 0.001）；三分之一患者的醛固酮水平升高（n = 8；304.29±57微克×毫升-1；p < 0.001）。其中17例患者在接受1毫克×24小时-1合成促肾上腺皮质激素的头四天，按照合成促肾上腺皮质激素试验方案进行了研究。并非所有病例都获得了对皮质醇的预期治疗效果，醛固酮释放的刺激作用显著且持续时间长。
