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现在已普遍承认脑水肿分为血管源性和细胞中毒性两种不同的基本类型。血管源性脑水肿实质上的变化是脑血管损伤,引起脑血管的通透性增加,在全身循环的流体静力压的作用下,使血清成份漏进周围的细胞外间隙。细胞中毒型的主要致病变化与细胞的新陈代谢,和各种细胞成份的离子转运的紊乱有关,或两者均有,以致造成这些细胞摄入液体而肿胀。这两种类型虽发生于两个不相同的过程,但可以同时共存或由一种引起另一种的出现。从神经外科的观点出发,血管源性脑水肿更为普遍和重要。因为它常并发于脑肿瘤、头部外伤和脑部炎症。下列综述也仅限于血管源性脑水肿。
It is now generally accepted that cerebral edema is divided into two basic types, vasogenic and cytotoxic. Substantial changes in vasogenic brain edema are cerebrovascular injuries that cause an increase in permeability of the cerebral blood vessels, allowing the serum components to leak into the surrounding extracellular space under the effects of systemic hydrostatic pressure. The major pathogenic changes in cell toxicity are associated with cellular metabolism, with disturbances in the ion transport of various cellular components, or both, causing these cells to ingest fluid and swell. Although these two types occur in two different processes, they can co-exist simultaneously or cause the other to occur one by one. From neurosurgical point of view, vasogenic brain edema is more common and important. Because it often complicated by brain tumors, head trauma and brain inflammation. The following reviews are also limited to vasogenic brain edema.