【摘要】 目的 :研究颅内低压家兔硬膜外腔注入自体静脉血后的治疗效果及机制。方法 :采用腰椎穿刺术造成家兔颅内低压 ,待稳定后 ,向其硬膜外腔注入自体静脉血 ,连续监测颅内压的变化。分析注射后 5d时脊椎、硬脑膜病理和脑脊液成分变化 ,以及侧脑室脉络丛上皮细胞超微结构变化。结果 :硬膜外腔注入自体静脉血后颅内压立即回升 ,并持续维持在正常水平 ,而注射生理盐水组在注射后颅内压也呈现短暂回升 ,但不能持续保持。病理检查可见硬膜外腔血栓机化 ,硬脊膜淋巴细胞浸润 ;电镜下显示侧脑室脉络丛上皮细胞出现分泌旺盛样改变。结论 :硬膜外血补片疗法对治疗颅内低压有显著疗效 ,其机制与物理性挤压、血栓堵塞脑脊液漏出点及脑脊液反应性分泌增加有关。更多还原

【Abstract】 AIM: To examine the effect of treatment with epidural blood patch on intracranial hypotension in rabbits and the possible mechanism.METHODS: The stable intracranial hypotension was made by lumbar puncture,then some blood was injected into the epidural space,and the changes of the intracranial pressure was determined continuously. Furthermore, the components of cerebrospinal fluid and the changes of choroid plexus epithelial cells, the spine and the dura were examined with electron microscope and light microscope 5 days later.RESULTS: The intracranial pressure was increased at once after the treatment with epidural blood patch and maintained at the normal level. The pathologic examinations showed that thrombus could be seen in the epidural space,and there was inflammatory reaction in the spinal dura mater. The results of electron microscope show that the choroid plexus epithelial cells appear actively for secretion.CONCLUSION: Intracranial hypotension could be effectively reversed by treatment with epidural blood patch. The possible mechanism might include physical squeeze,the leaking hole blocked and the cerebrospinal fluid increased by thrombus.更多还原