急性脳損傷・脳浮腫に対する高圧酸素療法—実験的・臨床的研究

EFFECTS OF HYPERBARIC OXYGENATION ON ACUTE BRAIN INJURY AND EDEMA:Clinical and Experimental Studies

I．はじめに

　近年高圧酸素療法の価値が再評価され，その臨床的応用が種々の方面で脚光をあびてきている。脳神経外科領域においても最近治療手段として高圧酸素加（oxygena—tion at high pressure；以下OHPと略す）を用いた報告が若干みられるようになつてきたが，まだその評価は確立していない。

　わたしたちは最近大阪大学附属病院特殊救急部に設置された高圧酸素手術室〔第1図）ならびに各種小型高圧酸素装置（第2図）を用いて，脳神経外科領域における高圧酸素療法について実験的研究をおこなうとともに，臨床的経験を重ねてきたが，今回は急性脳損傷・，脳浮腫に対するOHP療法の効果について報告する。

This paper is concerned with the evaluation of the protective effects of hyperbaric oxygenation (OHP) on acute brain injury and edema.

1) As the results of OHP therapy in 22 patients suffering from severe neurologic disorders (post-operative 8 cases and traumatic 14 cases), improve-ments of clinical neurological disorders were noticed in the half of the cases, and, in sonie of them, were also seen improvements of EEG. However, the most of these results were temporary and regressions occured after decompression.

2) Experimentally, the similar improvements of neurological behaviors and EEG were obtained in cats and dogs, which were subjected to acute brain injury produced by extradural balloon technique or intracarotid oil infusion technique by OHP treat-ments.

3) Another experiment was designed to study the effects of OHP treatments (3 ATA, 1 hour) on the brain injury and edema produced by intracarotid oil infusions in rabbits. The survival rate at the time of autopsy (3. 5 hours after the oil infusion) of OHP group was considerably higher than that of the con-trol group, and the difference between them was more obvious during the OHP treatments. Further-more, the influences of OHP on the destructed blood brain barrier, which was estimated by measuring the uptake ratios in brain tissue of RISA injected intravenously, were studied in the survivors, but no significant evidences were obtained to support the protective effects of OHP on them.