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[颅内手术后脑脊液酸碱平衡紊乱]

[Disorders of acid-base equilibrium in the cerebrospinal fluid after intracranial operations].

作者信息

Zwoliński J, Wroński J, Tota J, Mrzygłód H

出版信息

Neurol Neurochir Pol. 1980 May-Jun;14(3):313-9.

PMID:6774274
Abstract

The authors collected 27 patients after intracranial operations in whom the cerebrospinal fluid was investigated at least 3 times during 10 days. The patients were divided into 2 groups--a group of 16 patients with favourable outcome, and a group of 11 patients who died. On the basis of arithmetical means of pCO2 and HCO3 values hypothetical curves of the course of acid-base equilibrium in the blood and cerebrospinal fluid were plotted in both groups during 10 days. In the initial period metabolic acidosis was found in the cerebrospinal fluid and respiratory alkalosis in the blood in both groups. After several days metabolic alkalosis developed in the group of patients with favourable outcome while the metabolic acidosis in the cerebrospinal fluid was balanced. In the group with unfavourable outcome metabolic alkalosis in the blood was less evident and metabolic acidosis in the cerebrospinal fluid was increased. The authors think that metabolic alkalosis in the blood has a compensatory effect on metabolic acidosis in the cerebrospinal fluid and brain.

摘要

作者收集了27例颅内手术后的患者,这些患者在10天内至少接受了3次脑脊液检查。患者被分为两组,一组16例预后良好,另一组11例死亡。根据pCO2和HCO3值的算术平均值,绘制了两组患者在10天内血液和脑脊液酸碱平衡过程的假设曲线。在初始阶段,两组患者的脑脊液中均发现代谢性酸中毒,血液中出现呼吸性碱中毒。几天后,预后良好的患者组出现代谢性碱中毒,而脑脊液中的代谢性酸中毒得到平衡。在预后不良的患者组中,血液中的代谢性碱中毒不太明显,脑脊液中的代谢性酸中毒则有所增加。作者认为,血液中的代谢性碱中毒对脑脊液和大脑中的代谢性酸中毒具有代偿作用。

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