脑立体定向术临床应用

Hemodynamics in Patients with Buddchiari Syndrome during Venoauricular Bypass and Comparison between Two Kinds Operations

目的：探讨以脑立体定向术治疗震颤麻痹、癫痫、癌性疼痛、慢性精神病及颅内金属异物的方法和疗效。方法：用多功能脑立体定向仪对不同疾病毁损其不同的核团。结果：震颤麻痹１６６例共１８２次手术中治愈１３例次，显效１４５例次，有效１１例次，无效１２例次，死亡１例，有效率达９２９％；癫痫１８例，显效１１例，有效４例，无效３例，有效率达８３３％；癌性痛疼５例均显效；精神病３例，显效２例，有效１例；颅内异物２例均治愈。结论：脑立体定向术对以上疾病均取得了较为满意及良好的疗效，总有效率达９２４％。

Objective: To study hemodynamics in patients with BuddChiari syndrome(BCS) and the changes during venoauricular bypass,comparison with the spleenpneumonopexy.Methods: The hemodynamic parameterswere measured by SwanGanz catheter and extracardial artery and vein hemodynamometry immediately.Results: The patients with venoauricular bypass had lower CO before operation,the PVRI, PAP and PAWP reduced markedly,SVRI increased,After anesthesia induction,the HR increased,MBP and RPP decreased in both groups. CO,CI,SI,LVSWI and RVSWI in the venoauricular bypass group reduced significantly. The CO,CI,SI,LVSWI,RVSWI,PAWP,RAP and PAP increased obviously and SVRI and IVCP decreasd markedly after the opening of artifical blood vessel. The HR,BP and RPP increased continuously until operation was finished in spleenpneumometry group.Conclusion: The hemodynamics in BCS belongs to higher volume insystem of inferior vein and lower returned blood volume. General anesthesia may inhibite circulatory system. The returned blood volum will increase markedly when obstruction was relieved and collateral circulation set up, should be guarded against the heart failure and pneumonedema.