The effect of protein and blood cells on the flow-pressure characteristics of shunts
The effect of protein and blood cells on the flow-pressure characteristics of shunts
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DOI：
10.1097/00006123-199603000-00016
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发表时间：
1996-03-01
期刊：
影响因子：
4.8
通讯作者：
Harkness, W
中科院分区：
文献类型：
--
作者：
Brydon, HL;Bayston, R;Harkness, W
长期以来，人们一直认为高脑脊液蛋白浓度会对分流术的性能产生不利影响。然而，几乎没有实验证据支持这一观点，而且已经发表的少数报告可能会因为糟糕的实验设计或结果呈现而受到批评。建立了流量依赖的分流灌流模型。PS医疗流量控制瓣膜(PS Medical Corporation，Goleta，CA)和Cordis-Hakim瓣膜(Cordis Corporation，迈阿密，佛罗里达州)被注入0至9g/L蛋白质浓度的生理盐水-血浆溶液。血液悬浮液的稀释度从0.25%到1%也进行了研究。用简易压力计测量了阀门的开启和关闭压力，并对溶液的物理性质进行了研究。结果表明，这些瓣膜的性能在制造商指定的范围内，即使灌流液中的蛋白质浓度显著增加。此外，含蛋白质溶液的瓣膜开启和关闭压力低于对照溶液。因此，这种蛋白质没有损害分流功能，我们得出结论，脑脊液蛋白质含量升高的患者可以植入分流术。然而，血细胞确实会对性能产生不利影响，因此，出血性脑脊液患者不应接受分流术。
IT HAS LONG been assumed that a high cerebrospinal fluid protein concentration adversely affects the performance of shunts. There is little experimental evidence to support this viewpoint, however, and the few reports that have been published can be criticized for poor experimental design or presentation of results. A flow-dependent shunt perfusion model was constructed. PS Medical Flow Control valves (PS Medical Corporation, Goleta, CA) and Cordis-Hakim valves (Cordis Corporates, Miami, FL) were perfused with saline-plasma solutions in concentrations from 0 to 9 g/L of protein. Blood suspensions in dilutions from 0.25 to 1% were also studied. The opening and closing pressures of the valves were measured with a simple manometer, and the physical properties of the solutions were studied. The results indicated that the valves performed within the ranges specified by their manufacturers, even with markedly increased protein concentrations in the perfusate. Furthermore, the valve opening and closing pressures were lower with the protein-containing solutions than with the control solutions. Thus, the protein did not impair shunt function and we conclude that shunts can be inserted into patients who have elevated cerebrospinal fluid protein contents. However, blood cells did adversely affect performance and, therefore, patients with hemorrhagic cerebrospinal fluid should not receive shunts.