クモ膜下出血後脳血管攣縮に対するHypervolemic Hemorheological Therapy

抄録

Hypervolemic hemorheological therapy for cerebral vasospasm were evaluated in 46 cases operated within 72 hours after subarachnoid hemorrhage. Subjects were divided into 2 groups: the cases of mild hypoperfusion (CBF more than 35.1cc/100g/min), and those of severe hypoperfusion (CBF less than 35.1). In those of mild hypoperfusion, CBF showed negative correlation with Ht. The interrelationship between oxygen delivery and Ht showed optimal Ht between 35 and 40%. In those of severe hypoperfusion, Ht could exert less influence upon cerebral circulation and metabolism than in those of mild hypoperfusion, suggesting a limitation of hemodilutional therapy for severe vaso-spasm. Hypervolemic hemorheological therapy maintaining 35-40% of Ht and 10-12cm H₂O of CVP was considered to be effective from the viewpoint of clinical outcome and that of cerebral circulation.