排除低血氧及严重低血糖对脑水肿的影响,观察D—氨基半乳糖诱发的大鼠肝坏死脑含水量变化,发现小脑及脑干含水量明显增加,电镜上表现为大脑皮质、小脑及脑子星形细胞肿胀,HRP不透过血脑屏障。低浓度甘露醇可使全脑脱水,地塞米松只使脑干脱水。为此建议在肝昏迷早期即用低浓度甘露醇来防治脑水肿,而地塞米松的应用要慎重。 The effects of hypoxemia and severe hypoglycemia on cerebral edema were ruled out. The changes of brain water content in liver necrosis induced by D-galactosamine were observed. It was found that the water content of cerebellum and brainstem increased significantly. The electron microscopy showed the cerebral cortex, cerebellum and Brain stellate cells are swollen and HRP does not penetrate the blood-brain barrier. Low concentrations of mannitol can dehydrate the whole brain, and dexamethasone only dehydrates the brain stem. Therefore, it is recommended to use low-level mannitol to control cerebral edema in the early stage of hepatic coma, and the application of dexamethasone should be used with caution.