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血液稀释(Dd)治疗在德国已广泛应用于急性脑缺血,其根据是在用Hd治疗时观察到脑血流增加,而且在实验中与未用Hd的动物比较,发现脑梗塞范围缩小。然而,至今还没有足够的病例数证明,脑缺血病人经过Hd治疗后,预后改善;反之,在治疗后出现有害效应和不良病程。本文作者从病理生理学的观点对急性脑缺血用Hd治疗予以评价。病理生理学:Brown和Marshall在高粘滞综合征状态时指出,血浆交换后,脑血流量的大小不取决于血浆和全血粘度,而主要取决于脑的氧供应。只有在脑缺血的条件下,血液流动特性,特别是在微
Hemodilution (Dd) therapy has been widely used in acute cerebral ischemia in Germany on the basis that an increase in cerebral blood flow is observed during treatment with Hd, and that the range of cerebral infarction was found to be reduced in experiments compared with animals without Hd. However, to date, there are not enough cases to prove that the prognosis of cerebral ischemic patients after Hd treatment is improved; on the contrary, there are harmful effects and adverse courses after treatment. The authors evaluated Hd treatment of acute cerebral ischemia from a pathophysiological point of view. Pathophysiology: Brown and Marshall, in a state of hyperviscosity syndrome, state that the amount of cerebral blood flow after plasma exchange does not depend on the plasma and whole blood viscosity but mainly on the brain’s oxygen supply. Only in the condition of cerebral ischemia, the blood flow characteristics, especially in micro