Massei R, de Silva E, Grosso P, Robbiati B R, Infuso L, Ravagnati L, Altamura C A
J Neurosurg Sci. 1983 Apr-Jun;27(2):107-10.
Cerebral metabolic protection in patients submitted to carotid tromboendoarterectomy (TEA) can be made by means of drugs, both in the clamping acute intraoperative phase and in the immediate post-operative period. The knowledge that DPH has the property of reducing CMRO2, the lactates production and of increasing the cerebral level of glucose, glycogen and phosphocreatinine, has persuaded us to use this drug instead of barbiturate, as a therapeutic protection to prevent hypoxic damages to the nervous cell. Our series include 12 patients submitted to carotid TEA in whom cerebral metabolic protection has been obtained by means of DPH at the dosage of 15-17 mg/kg body wt. injected intravenously in about 15' just before clamping. Using this type of pharmacologic protection, we have not observed any of the undesired effects in the cardiocirculatory system described in the literature. The prompt awakening, the absence of neurological deficits, the absence of side-effects suggest that DPH can be used to provide a cerebral metabolic protection during TEA.
对于接受颈动脉内膜血栓切除术（TEA）的患者，无论是在术中急性夹闭期还是术后即刻，都可通过药物实现脑代谢保护。鉴于二苯妥英（DPH）具有降低脑氧代谢率（CMRO2）、减少乳酸生成以及提高脑内葡萄糖、糖原和磷酸肌酸水平的特性，我们决定使用该药而非巴比妥类药物，作为预防神经细胞缺氧损伤的治疗性保护措施。我们的系列研究纳入了12例接受颈动脉TEA的患者，通过在夹闭前约15分钟静脉注射15 - 17mg/kg体重的DPH来实现脑代谢保护。采用这种药物保护方式，我们未观察到文献中所描述的任何心血管系统不良反应。患者苏醒迅速、无神经功能缺损且无副作用，这表明DPH可用于在TEA期间提供脑代谢保护。
