| Japanese |
|---|
| Title | 急性期脳塞栓症例に対する軽微低脳温療法 |
|---|
| Subtitle | 症例 |
|---|
| Authors | 平田隆彦*, 大西佳彦**, 畔政和**, 赤松哲也**, 清水隆雄***, 坂口学***, 大谷良***, 大江洋史***, 成冨博章***, 澤田徹*** |
|---|
| Authors(kana) | |
|---|
| Organization | *大阪大学医学部麻酔科, **国立循環器病センター麻酔科, ***国立循環器病センター内科脳血管部門 |
|---|
| Journal | 循環制御 |
|---|
| Volume | 17 |
|---|
| Number | 3 |
|---|
| Page | 412-417 |
|---|
| Year/Month | 1996/ |
|---|
| Article | 報告 |
|---|
| Publisher | 日本循環制御医学会 |
|---|
| Abstract | 「要旨」発症後数時間以内の脳主幹動脈閉塞症例2例に, フェンタニール, ミダゾラム, ベクロニウム投与による全身麻酔下に約3日間内頚静脈温を33℃に維持する軽微低脳温療法を施行した. 超音波ドプラ法で算出した脳血流量および内頚動脈血酸素含量較差より求めた脳酸素代謝量と脳温(内頚静脈血温)の間には有意な正の相関を認め, 1℃温度が低下することにより症例1では8.8%, 症例2では11.4%脳酸素代謝量は低下した. 2名とも良好な経過をたどり軽快退院した. 急性脳塞栓患者に対する軽微低脳温療法は綿密な全身管理とりわけ厳重な循環管理の下に行えば安全かつ有効に行える. 本法の普及により急性脳塞栓症患者の予後の改善に大きく寄与するものと思われる. 「緒言」低体温に強力な脳保護作用のあることは従来より知られており1), 最近では救急医学領域で注目され行われている2). しかしながら急性脳塞栓症例に本法が行われたという報告はない. |
|---|
| Practice | 基礎医学・関連科学 |
|---|
| Keywords | Mild hypothermia, Thromboembolism, Cerebral ischemia, Cerebral oxygen metabolism |
|---|
| English |
|---|
| Title | Mild Hypothermic Therapy in Acute Thromboembolic Patients |
|---|
| Subtitle | |
|---|
| Authors | Takahiko Hirata, Yoshihiko Ohnishi, Masakazu Kuro, Tetsuya Akamatsu, Takao Shimizu, Manabu Sakaguchi, Ryo Ohtani, Hiroshi Oe, Hiroaki Naritomi, Tohoru Sawada |
|---|
| Authors(kana) | |
|---|
| Organization | Departments of Anesthesiology and Neurology, National Cardiovascular Center |
|---|
| Journal | Circulation Control |
|---|
| Volume | 17 |
|---|
| Number | 3 |
|---|
| Page | 412-417 |
|---|
| Year/Month | 1996/ |
|---|
| Article | Report |
|---|
| Publisher | Japan Society of Circulation Control |
|---|
| Abstract | Experimental studies have repeatedly shown that mild hypothermia protects brain from ischemic insults. However, mild hypothermic therapy has never been attempted clinically in stroke patients. We undertook mild hypothermic therapy in embolic stroke patients to evaluate its effectiveness in acute stroke. The therapy was induced in 2 patients with embolic occlusion of middle cerebral artery (MCA) or internal carotid artery, who were admitted within 2 hours after the onset. The therapy was initiated at 3-4 hours after stroke under general anesthesia by using fentanyl, midazolam and vecuronium. The brain temperature (the temperature of the internal jugular venous blood) was decreased to 33.0 ℃, which was maintained for 3-5 days. Modified CMRO2 calculated from the modified cerebral blood flow by ultrasonography and the difference of oxygen contents between internal carotic arterial and internal jugular venous blood showed significant decrease with the decrease of the brain temperature (8.8 %/℃ in case 1 and 11.4 %/℃ in case 2). Prior to the therapy, both eases had consciousness disturbance and hemiplegia. At 1 month after stroke, case 1 had minimum neurlogic deficits, although his CT showed small infarction. Case 2 had little neurologic deficits and no infarction on CT despite persistent MCA occlusion. The results suggest that the mild hypothermia protects neuronal cells from ischemic insults and is potentiallly useful for the treatment of acute embolic stroke. (Circ Cont 17：412〜417, 1996) |
|---|
| Practice | Basic medicine |
|---|
| Keywords | Mild hypothermia, Thromboembolism, Cerebral ischemia, Cerebral oxygen metabolism |
|---|