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暴发型流行性脑脊髓膜炎(简称流脑)是发病急剧、病情凶险的疾病之一。目前对其发病机理尚不十分清楚,治疗难度大,病死率高。近年来国外对本病某些方面作了深入的探讨,现将有关的几个问题综述如下: 脑膜脑炎型发病机理及治疗脑膜炎双球菌内毒素侵入血管后,使脑血管发生痉挛和脑血管通透性增加,血浆渗出血管外,形成脑水肿。而颅腔是密闭系统,容量固定,对容量的改变耐受性差,因此颅内压增高可致脑缺血、脑脊液流动阻塞、脑血流中断,最后脑干下移发生脑疝。这一系列病理变化是暴发型流脑病死率高的重要因素。颅内压上升与脑灌注压(CPP)有密切关系,而CPP受流入压(颈动脉平均压)和流出压(颅蛛网膜静脉压CSCVP)影响,CSCVP与颅内压相等,因此CPP取决于
Outbreak of epidemic meningococcal meningitis (referred to as meningitis) is one of the rapid onset of disease dangerous disease. At present its pathogenesis is not yet very clear, difficult to treat, high mortality. In recent years, some aspects of this disease made in-depth discussion of the disease, the relevant issues are summarized below: The pathogenesis of meningoencephalitis type and treatment of meningococcus endotoxin invade the blood vessels, so that cerebral vasospasm and brain Increased vascular permeability, plasma exudation of blood vessels, the formation of cerebral edema. The cranial cavity is a closed system, a fixed capacity, poor tolerance to changes in capacity, so intracranial pressure can cause cerebral ischemia, cerebrospinal fluid flow obstruction, cerebral blood flow interruption, and finally the brain stem hernia. This series of pathological changes is an important factor in fulminant meningitis. Increased intracranial pressure and cerebral perfusion pressure (CPP) are closely related to the CPP by the inflow pressure (average carotid artery pressure) and outflow pressure (CSF CSCVP), CSCVP and intracranial pressure is equal, so CPP depends on