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[在使用药物制剂和高压氧疗保护严重颅脑创伤患者免受缺氧的条件下的适应机制]

[The mechanisms of adaptation in severe trauma to the brain under conditions protecting it from hypoxia with pharmacological preparations and hyperbaric oxygenation].

作者信息

Usenko L V, Kligunenko E N

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 1992 Jan-Feb(1):19-24.

PMID:1316697
Abstract

From analysis of the adaptation mechanisms forming in severe brain trauma in 49 patients during its protection from hypoxia by combined administration of subnarcotic doses of sodium oxybutyrate and sodium thiopental in a bolus and an early course of hyperbaric oxygenation (HBO) the authors revealed the adaptation and disadaptation processes determining the outcome of the treatment. Since activation of the system of stress realizing biogenic amines promotes disadaptation processes, whatever the outcome, it is recommended to begin HBO after their stabilization. The character of changes of the lactate and pyruvate levels in blood flowing to and from the brain allowed the authors to distinguish the occurrence of a negative A-B gradient according to pyruvate after the first trial HBO session as a market of adaptation and a biochemical criterion of the expediency of prescribing a course of HBO.

摘要

通过对49例重度脑外伤患者在联合给予亚麻醉剂量的羟丁酸钠和硫喷妥钠大剂量推注以及早期高压氧治疗(HBO)以保护其免受缺氧过程中形成的适应机制进行分析,作者揭示了决定治疗结果的适应和适应不良过程。由于实现生物胺的应激系统激活会促进适应不良过程,无论结果如何,建议在其稳定后开始HBO治疗。流入和流出大脑的血液中乳酸和丙酮酸水平的变化特征使作者能够区分首次HBO治疗后根据丙酮酸出现的负A - B梯度,作为适应的标志以及开具HBO疗程适宜性的生化标准。

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