动脉瘤手术后颅内压升高的治疗。
The treatment of raised intracranial pressure following aneurysm surgery.
作者信息
Fearnside M R, Adams C B
出版信息
J Neurol Neurosurg Psychiatry. 1980 Nov;43(11):957-61. doi: 10.1136/jnnp.43.11.957.
The effect of intravenous mannitol infusion and withdrawal of cerebrospinal fluid on the intracranial pressure and clinical state was studied in 26 patients with raised intracranial pressure after direct surgery for ruptured aneurysm. Each method decreased the mean intracranial pressure by about 60% of the pre-treatment level. The maximal decrease following mannitol occurred after 60-90 minutes and generally lasted between three and four hours. The effects of mannitol did not decrease when repeated infusions were necessary. Rebound increases in the intracranial pressure following infusion were not observed. Withdrawal of cerebrospinal fluid lowered the intracranial pressure immediately and the effect persisted for approximately 60 minutes. This could be repeated as often as necessary and was without systemic disturbance, although a patent intraventricular catheter was necessary. The two methods could be used simultaneously.
对26例破裂动脉瘤直接手术后颅内压升高的患者，研究了静脉输注甘露醇和脑脊液引流对颅内压及临床状态的影响。每种方法均使平均颅内压降低至治疗前水平的约60%。甘露醇输注后最大降幅出现在60 - 90分钟后，一般持续3至4小时。必要时重复输注甘露醇，其效果并未降低。未观察到输注后颅内压出现反跳性升高。脑脊液引流可立即降低颅内压，且效果持续约60分钟。必要时可反复进行，且无全身干扰，不过需要一根通畅的脑室内导管。这两种方法可同时使用。
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