脳循環代謝モニターシステムの開発—I．アルゴンガスおよび医用質量分析器を用いた脳血流量測定法の検討

Monitoring System of Cerebral Blood Flow and Cerebral Metabolism:Part I. Measurement of cerebral blood flow and cerebral oxygen consumption by use of argon and mass spectrometry in clinical cases

　脳循環代謝の経日的なモニターができれば，脳血管障害急性期例についての病態の推移の把握や，高度の脳血管閉塞を有するhigh risk症例の外科手術中の脳循環代謝面よりの管理や，また例えばバルビタール療法中の症例の脳循環代謝面よりの管理が可能となり，治療方針の決定や種々の治療についての効果判定など大いに役立つものと考えられる。

　しかし現在までのところ，臨床例についての脳循環代謝のモニター法は確立されていない。

To develop the monitoring system of cerebral blood flow and cerebral metabolism, we tried to use argon and medical mass spectrometry in various cases of cerebrovascular disease. Quan-titative accuracy of mass spectrometry using silastic catheter was examined in the water bath at a controlled temperature of 37℃. The system was shown to be quantitatively accurate in a water equilibrated with accurately known argon gas mixtures. The inditial responses were identical in the different silastic catheters.

Cerebral blood flow was measured following procedures; The mass spectrometry has been previously balanced for oxygen, carbon dioxide, arogan and nitrogen in a constant temperature water bath with a calibration gas mixture. The right femoral artery was cannulated by a 15 cm long 21 gauge needle with a 19 gauge Teflon catheter sleeve. The spectrometer silastic catheter was inserted through the intra-arterial catheter so the silastic-covered porous tip extends above the tip of the Teflon catheter and lies directly in the blood stream. A similar needle and sleeve was inserted just lateral to the common carotid artery at midneck and the spectrometer catheter was inserted until slight resistance was met indicating the tip was in the jugular bulb.