期刊文献+

过度通气对62例重型颅脑损伤的临床观察 被引量:3

Clinical observation of 62 cases during hyperventilation in patients with severe traumatic brain injury
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摘要 目的 研究过度通气对重型颅脑损伤(STBI)患者颅内压(ICP),脑氧摄取,血清神经元特异性烯醇化酶(NSE)含量的影响.方法 62例重型颅脑损伤患者(GCS≤8分),随机分成治疗组和对照组,治疗组采用过度通气使呼气末二氧化碳分压(PetPaCO,)维持在(4~4.67kPa)2h,同时监测颅内压,颈静脉氧饱和度(SjvO2),动脉血氧饱和度(SaO2).结果 重型颅脑损伤的患者行过度通气2h后,ICP有不同程度的下降,平均下降(0.53 kPa),脑氧摄取与血清NSE含量没有统计学差异.结论 轻度过度通气有效地降低了颅内压,没有导致脑组织缺血缺氧及脑组织损伤,不能放弃这种简单有效的降低颅内压方法. Objective: The study of severe traumatic brain injury (STBI) was to investigate the effects of hyperventilation on intracranial pressure (ICP), brain extraction oxygen, serum neuron- specific enolase(NES). Methods 62 patients(GCS 〈 8) with severe traumatic brain injury were divided into treatment and control groups at random, keeping end-tidal carbon dioxide pressure (PetPaCO2 ) at 4-4. 67kPa for 2 hours by hyperventilation in treatment groups, simultaneously monitoring intracranial pressure saturation of jugular venous oxygen (SjvO2 ), saturation of arterial oxygen( SaO2 ). Results ICP had declined by varying degrees (average 0.53 kPa). There were no statistics differences both SaO2 and serum NES. Conclusions Mild hyperventilation effectively reduced ICP, did not result in brain tissues of hypoxic-isehemic injury. Do not giving up such a simple and effective method of reducing ICP.
出处 《临床神经外科杂志》 CAS 2013年第6期362-364,共3页 Journal of Clinical Neurosurgery
关键词 重型颅脑损伤 过度通气 颅内压 血清NSE severe traumatic brain injury hyperventilation intracranial pressure serum NES
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参考文献13

  • 1陈静,卢明,彭立辉,石磊,滕晓华,曾瑜.重型颅脑损伤并发急性呼吸窘迫综合征的高危因素及综合治疗[J].临床神经外科杂志,2011,8(2):72-73. 被引量:5
  • 2Muizelaar JP,Marmarou A,Ward J,et al.Adverse effects of prolonged hyperventilation in patients with severe head injury:a randomized clinical trial[J].J Neurosurg,1991,75:731.
  • 3Fortune JB,Feustel PJ,Graca L,et al.Effect of hyperventilation,mannitol and ventriculostomy drainage on cerebral blood flow after head injury[J].J Trauma,1995,39:1091.
  • 4Granholm L,Lukjanova L,Siesjo BK.The effect of marked hyperventilation upon tissue levels of NADH,lactate,pyruvate,phosphocreatine,and adenosine phosphates of rat brain[J].Acta Physiol Scand,1969,77:179.
  • 5Forbes ML,Clark RS,Dixon CE,et al.Augmented neuronal death in CA3 hippocampus following hyperventilation early after controlled cortical impact[J].J Neurosurg 1998; 88:549.
  • 6Newell,David W,Weber,et al.Effect of Transient Moderate Hyperventilation on Dynamic Cerebral Autoregulation after Severe Head Injury[J].Neurosurgery,1996,39:35.
  • 7Barone FC,Clark RK,Price WJ,et al.Neuronspecific Enolase Increase in Cerebral and Systemic Circulation Following Focal Ischemia[J].Brain Res,1993,623:77.
  • 8Celtik C,Acunas B,0ner N,et al.Neuron specific Enolase as a Marker of the Severitv and Outcome of Hypoxic Ischemic Encephalopathy[J].Brain Dev,2004,26:398.
  • 9甘国胜,陈利民,王焱林,王成夭,陈敏,丘伟.急性颅脑外伤手术患者血清NSE的测定及意义[J].中国康复,2006,21(4):242-244. 被引量:11
  • 10王保国.实用呼吸机治疗学[J].第1版.北京:人民卫生出版社,2002:126.

二级参考文献27

  • 1邢鸣,赵有发,张远明.急性重型颅脑损伤后急性肺损伤和急性呼吸窘迫综合征的治疗体会[J].临床神经外科杂志,2007,4(1):39-41. 被引量:13
  • 2刘俊杰 赵俊.现代麻醉学,第2版[M].北京:人民卫生出版社,1998.643.
  • 3中华医学会呼吸病学分会.急性肺损伤/急性呼吸窘迫综合征的诊断标准(草案)[J].中华结核和呼吸杂志,2000,23(4):203-203.
  • 4Joseph DK, Dutton RP, Aarabi B, et al. Decompressive laparotomy to treat intractable intracranial hypertension after traumatic brain injury. J Trauma, 2004, 57(4) :687 -693.
  • 5顾大镛.升高的腹内压、胸内压和颅内压之间的关系[J].国外医学:创伤与外科基本问题分册,1998,19(1):53-54.
  • 6Diebel LN, Dulchavsky SA, Wilson RF. Effect of increased intra - abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma, 1992, 33(1) :45 -49.
  • 7Saggi B, Sugerman H J, Ivatury R, et al. Abdominal compartment syndrome. J Trauma, 1998, 45 : 1466 - 1471.
  • 8Meldrum DR, Moore FA, Moore EE, et al. Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg, 1997, 174(6) :667 -673.
  • 9Bloomfield GL, Dalton JM, Sugerman H J, et al. Treatment of increasing intracranial pressure secondary to the acute abdominal compartment syndrome in a patient with combined abdominal and head trauma. J Trauma, 1995, 39(6) :1168 - 1670.
  • 10[1]CELTIK C,ACUNAS B,ONER N,et al.Neuron-specific Enolase as a Marker of the Severity and Outcome of Hypoxic Ischemic Encephalopathy[J].Brain Dev (S0378-7604),2004,26(6):398-402.

共引文献28

同被引文献50

  • 1包映晖,江基尧,朱诚,卢亦成,蔡如珏,马驰原.过度通气对动物颅内高压时脑组织氧及二氧化碳分压的影响[J].第二军医大学学报,2001,22(z1):28-30. 被引量:3
  • 2罗杰明,田明端.亚低温复合中度过度通气对重型颅脑损伤病人脑氧供需平衡的影响[J].国际医药卫生导报,2004,10(18):71-73. 被引量:1
  • 3任晓旭.意识障碍量表在儿科急救中的应用[J].中国小儿急救医学,2007,14(3):185-188. 被引量:1
  • 4小儿危重病例评分试用协作组.小儿危重病例评分法草案临床应用的评价[J].中华儿科杂志,1998,36(7):370-373.
  • 5Leteurtre S, Duhamel A, Deken V. et al. Daily estimation of the severity of organ dysfunctions in critically ill children by using the PELOD-2 score[J]. Crit Care,2015,19:324.
  • 6Wang H, Siddharthan V, Kesler KK, et al. Fatal neurological re- spiratory isufficiency is common among viral encephalitides [J]. J Infectious Dis,2013, 208(8) :573-583.
  • 7Morrey JD, Siddharthan V, Wang H, et al. Respiratory insuffi- ciency correlated strongly with mortality of rodents infected with West Nile virus[J]. PLoS ONE ,2012, 7(6) : e38672.
  • 8Bale Jr JF. Virus and immune-mediated encephalitides : epide- miology, diagnosis, treatment, and prevention [J]. Pediatr Neu- rol,2015,53: 3-12.
  • 9Glimaker M, Johansson B, Halldorsdottir H, et al. Neuro-in- tensive treatment targeting intraeranial hypertension improves outcome in severe bacterial meningitis: an intervention-control Study[J]. PLoS ONE ,2014, 9(3) : 91976.
  • 10Kramer AH. Viral encephalitis in the ICU [J]. Crit Care Clin, 2013, 29(3): 621-649.

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