徐放性薬剤と脳槽ドレナージ併用による脳血管攣縮の治療

Treatment of Vasospasm after Ruptured Cerebral Aneurysms by'Pellet-Cisternal-Drain: PCD' Containing Sustained-release Vasodilators

I．はじめに

　くも膜下出血後の遅発性脳血管攣縮の予防および治療に関しては，数多くの報告がなされているが，まだ，これを完全に解決し得た方法は見つかっていない．

　我々は，血管攣縮の最終段階としての，平滑筋へのCaイオンの細胞内への流入を阻止して，この問題を解決するために，diltiazemあるいは塩酸パパベリンを，局所に持続的に投与して，血管を拡張させることを企図した．

Diltiazem or papaverine hydrochloride as vasodila-tors were polymerized with silicon polymer (MDX-4- 4210 : Dow Co.) . The silicon pellets containing the drugs were placed in cisternal drainage tubes made of silicon, and used for the continuous cisternal drainage after the operations of ruptured cerebral aneurysms.

This system was tentatively termed 'pellet-cisternal-drain ; PCD'.

The rate of diffusion of the drug from the pellets was examined in 30 patients who underwent surgery for ruptured cerebral aneurysms in the acute phase on the 0 - 4th postical days.