摘要
目的 观察电项针治疗对成人急性缺氧缺血性脑病（HIE）患者脑氧利用率（O2UCc）的影响,并探讨电项针治疗HIE的作用机制.方法 将入选的74例HIE患者按随机数字表法分为电项针治疗组（38例）和常规治疗组（36例）.常规治疗组给予常规药物治疗,包括脱水、降颅压、醒脑、营养神经、脑保护等;电项针治疗组在药物治疗基础上于发病后3～5 d给予电项针治疗,每次30 min,每日1次,均2周为1个疗程.治疗前后采集颈内静脉及股（桡）动脉血各1 ml,用血气分析仪检测动脉血氧饱和度（SaO2）、颈内静脉血氧饱和度（SjO2）,计算O2UCc,并比较两组治疗前后O2UCc的变化及不同水平O2UCc患者的预后.结果 电项针治疗组和常规治疗组O2UCc〈25%和O2UCc正常（25%～45%）患者治疗前后O2UCc无明显变化;O2UCc〉45%患者治疗后O2UCc水平较治疗前明显下降,差异有统计学意义[电项针治疗组：（38.60±4.78）%比（52.21±4.49）%,常规治疗组：（48.33±2.42）%比（53.17±4.26）%,均P〈0.01],且电项针治疗组优于常规治疗组（P〈0.01）.O2UCc〈25%患者病死率明显高于O2UCc〉45%和O2UCc正常者（40.0%比12.9%和15.4%,均P〈0.05）.结论 O2UCc〈25%的HIE患者病情重,病死率高,预后差;电项针能够通过改善椎基底动脉循环,及时恢复大脑血流,改善脑组织缺血缺氧状况,降低O2UCc,恢复正常脑氧代谢.
Objective To observe the clinical effectiveness of the nucha electrical acupuncture on cerebral oxygen utilization coefficient （OzUCc） in hypoxic ischemic encephalopathy （HIE） patients, and to investigate the mechanism of the treatment. Methods Seventy-four HIE patients were randomly divided into nucha electrical acupuncture group （38 cases） and routine treatment group （36 cases）. The patients in both groups were treated with conventional medical therapies, including dehydration, intracranial pressure reduction, resuscitation, neurotrophy, brain protection, and so on, while in nueha electrical acupuncture group, additionally, the patients received the nucha electrical acupuncture 3 - 5 days after onset, once 30 minutes/day, and 2 weeks constituting one therapeutic course. 1 ml of blood was collected from internal jugular vein and 1 ml was from femoral artery or radial artery, then the arterial oxygen saturation （SaO2） and internal jugular venous oxygen saturation （SjO2） were assayed by blood gas analyzer, and OzUCe was calculated. The prognosis of HIE patients with different OzUCc were compared, and the changes of O2UCc before and after therapy were compared between the two groups. Results In both groups, there was no manifest change before and after therapy in the patients with O2UCc〈25% or normal O2UCc （25%-45%）, and the level of O2UCc in patients with 〉45 % was significantly decreased after treatment compared with that before treatment （nucha electrical acupuncture group： （38.60±4.78）% vs. （52.21±4.49）%, routine treatment group： （48.33±2.42）% vs. （53.17!4.26）%, both P〈0.01], and the therapeutic effectiveness was better in nucha electrical acupuncture group than that in routine treatment group （P 〈 0.01）. The mortality of patients with O2UCc〈25% was significantly higher than that with O2UCc〉 45% and normal O2UCc （40.0% vs. 12.9%, 15.4%, both P〈0. 05）. Conclusion The patient with O2UCc（25% is under severe condition with high mortality and bad prognosis. The treatment of nucha electrical acupuncture can improve vertebral-basilar artery circulation, recover cerebral blood flow, improve ischemia and hypoxia status, lower O2UCc, and recover normal cerebral oxygen metabolism.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2010年第6期352-354,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
电项针
缺氧缺血性脑病
脑氧利用率
Nucha electrical acupuncture
Hypoxic ischemic encephalopathy
Cerebral oxygen utilization coefficient
