• 作者： 陳幸一；林進丁；蔡作雍
• 中文摘要： 在Pentobarbital麻醉之大白鼠，劇烈之腦部壓迫在2至3分鐘?引發致死之肺水腫出血。我們利用一種「局部稱重法」 以觀察全身血量移積的現象。在壓迫腦部之後，併合血壓上升之際，胸部之重量增加而腹-臀腿部（下半身）重量下降。 局部重量之變化相當急速，大約在壓迫腦部之開始後10秒?達一高?（4?6公克），雖然血壓及心跳在壓迫腦部後2?3 分鐘呈現死亡前之下降，但是局部重量?停留在高?附近而無回復之現象。切除雙側頸部迷走神經僅消除心緩反應，而不 影響升壓反應，血量分佈變化以及肺水腫出血之程度。交感神經抑制劑，包括腎上腺素清除劑Reserpine ，神經節阻斷劑 Hexamethonium及甲型抑制劑phenoxyenzamine均顯著地抑制了壓迫腦部後之升壓反應及血量分佈變化，並且防止肺病 變之發生。在壓迫腦部之前，阻斷腹部循環可以避免肺病變之發生，但是阻?臀腿部循環則無顯著作用。結果顯示劇烈之 整迫腦部?生急速而不可逆之血量移積，後者主要由腹部循環移轉於肺?。此種變化乃由於激發中樞交感神經系統，經由 甲型腎上腺素性接受器之作用而引發體循環阻力性血管或加上容積性血管之收縮而?生。肺循環大量而急速之血量沈積 在短時間?造成肺循環高血堅以致引發充血、水腫以及出血。
• 英文摘要： In rats anesthetized with pentobarbital, cerebral compression (CC) by impacting a space-occupying plasticine mass into the cranium produced severe pulmonary edema and hemorrhage (peh) in 2 to 3 min. We used a method of regional weighing that allows a gross observation of the blood volume distribution. Concomitant with the pressor response, there was a sustained increase in the thoracic weight accompanying a decrease in the abdomen-hindquarters weight immediately upon CC. The regional weight changes were rather abrupt, reaching a maximum of 4 to 6 gm in 10 sec. Bilateral cervical vagotomy did not affect the pressor response, the blood volume distribution and the degree of peh Sympathoadrenergic blockades with reserpine, hexamethonium and phenoxybenzamine largely reduced the pressor response, the blood volume translocation and the degree of peh. An antecedent occlusion of the abdominal circulation prevented the genesis of peh. Occlusion of the hindquarters circulation only slightly reduced the degree of peh. The results suggest that cerebral compression causes an abrupt and irreversible blood volume shift mainly from the abdominal circulation to the lungs. The translocation of blood volume is produced by an intense sympathetic activation that induces systemic vasoconstriction of the resistance vessels, and probably the capacitance vessels as well. An accumulation of large amounts of blood in the lungs results in pulmonary hypertension, congestion, edema, disruption of the blood vessels and hemorrhagic changes within a short period of time.
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