CAJ | 학술논문

目的探讨23.4%高渗盐水(HTS)对重症蛛网膜下腔出血(SAH)患者颅内压、脑灌注压、脑血流量(CBF)的影响.方法 16例重症SAH患者(GCS≤8分)在颅压升高时接受静脉输注23.4%HTS,监测用药前及用药后30、60、90、120、150、180 min的颅内压(ICP),平均动脉压(MAP),脑灌注压(CPP)及脑血流速度(FV).结果用药后30 min可见ICP显著降低,同时MAP、CPP及FV显著升高(P<0.05),ICP显著降低可持续180 min,CPP和FV的改善持续约90 min(P<0.05).结论 HTS能显著降低重症SAH患者的ICP,改善脑组织灌注,可用来纠正脑缺血引起的病生理变化.
목적 탐토23.4%고삼염수(HTS)대중증주망막하강출혈(SAH)환자로내압、뇌관주압、뇌혈류량(CBF)적영향.방법 16례중증SAH환자(GCS≤8분)재로압승고시접수정맥수주23.4%HTS,감측용약전급용약후30、60、90、120、150、180 min적로내압(ICP),평균동맥압(MAP),뇌관주압(CPP)급뇌혈류속도(FV).결과 용약후30 min가견ICP현저강저,동시MAP、CPP급FV현저승고(P<0.05),ICP현저강저가지속180 min,CPP화FV적개선지속약90 min(P<0.05).결론 HTS능현저강저중증SAH환자적ICP,개선뇌조직관주,가용래규정뇌결혈인기적병생리변화.
Objective To investigate the effect of 23.4% hypertonic saline(HTS)on intracranial pressure(ICP), cerebral peffusion pressure(CPP), cerebral blood flow(CBF)in poor-grade patients with subarachnoid hemorrhage(SAH).Methods Sixteen patients(Glasgow coma score ≤ 8)with poor-grade SAH received 23.4% hypertonic saline intravenously for elevated ICP.ICP, mean arterial pressure(MAP), CPP and the middle cerebral artery flow velocity(FV)were observed and recorded before and at 30, 60, 90,120, 150, 180 min after the injection respectively.Results Thirty minutes postinfusion, a significant increase in MAP, CPP, FV was seen together with a decrease in ICP(P<0.05).ICP remained reduced for 180 minutes, CPP and FV remained elevated for 90 minutes(P < 0.05).Conclusions HTS can significantly decrease ICP and improve CBF in patients with poor-grade subarachnoid hemorrhage and may be used for reversal of pathophysiologic changes caused by cerebral ischemia.