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[缺氧后脑病的强化治疗]

[The intensive therapy of posthypoxic encephalopathy].

作者信息

Shchukovskiĭ V V, Aleksandrovich L M, Borisov A Iu, Khazov B E, Belov O V, Fisun A M

出版信息

Anesteziol Reanimatol. 1996 May-Jun(3):40-3.

PMID:8967618
Abstract

A complex of therapeutic measures including hyperbaric oxygenation combined with heparin and endolumbal injection of glucocorticoids, proteolysis inhibitors, was carried out in 49 patients aged 16 to 95 with posthypoxic encephalopathy caused by mechanical asphyxia (11 patients,) carbon monoxide (12 cases), narcotics (18 cases), and closed craniocerebral injury (8 patients). Lipid peroxidation, some parameters of homeostasis, electrolyte, acid-base, and gaseous composition of the blood and liquor were studied before and during treatment. Positive clinical results were attained in 88.6% cases. Multiple-modality treatment of this patient population led to normalization of the coagulation potential of the blood and of the content of fibrinogen, but did not appreciably affect the electrolyte balance, acid-base, and gaseous composition of the blood. The activity of superoxide dismutase normalized, but the concentration of malonic dialdehyde increased, with the levels of dienic conjugates and nonerythrocytic hemoglobin being unchanged; however, the metabolic acidosis in the liquor still persisted.

摘要

对49例年龄在16至95岁之间、因机械性窒息(11例)、一氧化碳中毒(12例)、麻醉品中毒(18例)和闭合性颅脑损伤(8例)导致缺氧后脑病的患者实施了一系列治疗措施,包括高压氧治疗联合肝素以及在腰椎硬膜外注射糖皮质激素、蛋白水解抑制剂。在治疗前和治疗期间研究了脂质过氧化、内环境稳态的一些参数、血液和脑脊液的电解质、酸碱及气体成分。88.6%的病例取得了积极的临床效果。对这一患者群体的多模式治疗使血液凝固潜能和纤维蛋白原含量恢复正常,但对血液的电解质平衡、酸碱及气体成分没有明显影响。超氧化物歧化酶的活性恢复正常,但丙二醛浓度升高,二烯共轭物和非红细胞血红蛋白水平未变;然而,脑脊液中的代谢性酸中毒仍然存在。

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