Cerebrospinal fluid drainage and cranial decompression prolong survival in rats with fulminant hepatic failure.
Cerebrospinal fluid drainage and cranial decompression prolong survival in rats with fulminant hepatic failure.
复制标题
脑脊液引流和颅脑减压可延长暴发性肝衰竭大鼠的生存期。
DOI：
10.1111/j.1432-2277.2006.00322.x
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Nguyen,JustinH
中科院分区：
文献类型：
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作者：
Yamamoto,Satoshi;Steers,JefferyL;WharenJr,RobertE;Eckman,ChristopherB;Nguyen,JustinH
暴发性肝功能衰竭(FHF)是一种破坏性疾病。肝移植是最终的治疗方法。然而，这些患者中有三分之一在获得捐赠者之前就死于脑水肿。脑脊液(CSF)引流和去骨瓣减压术已被用于治疗脑外伤和半球卒中的脑水肿。然而，它们在与FHF相关的脑水肿中的作用还没有被研究。在这项研究中，我们评估了脑脊液引流和去骨瓣减压术对FHF大鼠存活率的潜在影响。在脑脊液引流实验中，所有动物均放置脑室造口。5天后用D-氨基半乳糖诱导FHF。那些进入昏迷阶段的FHF大鼠要么接受脑脊液抽吸，要么不接受脑脊液抽吸。在单独的实验中，研究大鼠接受了去骨瓣减压术或假手术。5 后诱发FHF。脑脊液引流组和去骨瓣减压组大鼠的存活率分别为53.2 ± 1.1vs.48.7 ± 1.5 h(P= 0.031)和69.4 ± 3.9vs.53.7 ± 3.2 h(P= 0.009)。综上所述，这些发现提示脑脊液引流和去骨瓣减压术可能增加肝移植的机会窗。
Fulminant hepatic failure (FHF) is a devastating disease. Liver transplantation is the definitive treatment. However, a third of these patients die due to brain edema before a donor becomes available. Cerebrospinal fluid (CSF) drainage and decompressive craniectomy have been used to treat brain edema in brain trauma and hemispheric stroke. However, their role in brain edema associated with FHF has not been examined. In this study we evaluated the potential effects of CSF drainage and decompressive craniectomy on survival in FHF using an experimental model in rats. In CSF drainage experiments all animals had ventriculostomy placed. Five days later FHF was induced withd‐galactosamine. Those FHF rats that progressed into comatose stages either received CSF aspiration or did not. In separate experiments the study rats had either a decompressive craniectomy or a sham procedure. FHF was induced 5 days later. We found that both CSF drainage and decompressive craniectomy significantly increased survival of FHF rats compared with the controls: 53.2 ± 1.1 vs. 48.7 ± 1.5 h (P= 0.031), and 69.4 ± 3.9 vs. 53.7 ± 3.2 h (P= 0.009), respectively. In conclusion, these findings suggest that CSF drainage and decompressive craniectomy may increase the window of opportunity for liver transplantation.