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报道临床应用ACTH治疗脑瘤所致脑水肿30例的结果。本组30例中,恶性胶质瘤20例,脑转移瘤6例,脑膜瘤3例,垂体瘤1例。入院时均有程度不等的颅内压增高,8例并发脑疝。CT检查证实占位病变周围伴明显脑水肿。手术前后采用ACTH静脉滴注缓解脑水肿疗效显著,其中胶质瘤之显效率为50%,脑转移瘤为100%。总显效率为60%。脑瘤病程中出现ADH分泌失常综合征,引起ADH/ACTH平衡失调,以ADH分泌偏亢、ACTH功能不足为主,导致脑水肿。ACTH的优点在于它既能兴奋其周围靶腺,又具有肾上腺外的作用,直接改善脑细胞的功能使之正常化,从而促使脑水肿迅速消退。文中还就ACTH的作用机制进行了初步探讨。
Report the clinical application of ACTH treatment of brain tumor-induced brain edema in 30 cases of the results. The group of 30 cases, 20 cases of malignant glioma, brain metastases in 6 cases, 3 cases of meningioma, pituitary tumor in 1 case. When admitted to the hospital, varying degrees of increased intracranial pressure, 8 cases of complicated hernia. CT examination confirmed the presence of clear lesions around the brain edema. The use of ACTH intravenous drip before and after surgery to alleviate cerebral edema significant effect, in which markedly effective glioma was 50%, 100% brain metastases. The total efficiency of 60%. ADH secretion syndrome appears in the course of brain tumor, causing ADH / ACTH balance disorders, partial secretion of ADH hyperactivity, ACTH dysfunction, leading to cerebral edema. The advantage of ACTH is that it not only excites the surrounding target gland but also has the effect of adrenal gland, directly improves the function of brain cells and normalizes them, and prompts cerebral edema to subside rapidly. The article also discussed the mechanism of ACTH.