【摘要】 目的观察参附注射液(SF)对创伤性脑损伤病人血流动力学及脑氧供需平衡的影响。方法30例伴有颅内高压症行开颅减压术的创伤性脑损伤病人,GCS(glasgowcomascale)评分≤7,随机均分为对照组(NS组)和SF组,SF组在麻醉诱导前静脉泵注SF100mL/h,输注时间为1h;NS组于同一时间给予0.9%生理盐水100mL,分别于输注前(T1)、切开硬脑膜后即刻(T2)、切开硬脑膜后5min(T3)3个时点同步采集颈静脉球和桡动脉血行血气分析,并计算动脉(CaO2)、颈静脉球血氧含量(CjvO2)、脑氧摄取率(CEO2)。结果给药后在开颅减压过程中,SF组SBP、CEO2较NS组稳定,组间有明显差异(P<0.05或P<0.001),SF组SjvO2、CjvO2明显高于NS组(P<0.05);DBP、HR、SaO2、CaO2、PaCO2组间无明显差异(P>0.05)。结论参附注射液可能在一定程度上稳定创伤性脑损伤病人开颅减压术中的血流动力学,有助于改善脑的氧供需平衡。更多还原

【Abstract】 [Objective] To investigate the effects of Shenfu injection(SF) on haemodynamics and balance between cerebral oxygen delivery and consumption in traumatic brain injury patients. [Methods] 30 patients with traumatic brain injury and Glasgow coma scale(GCS)≤7, needed operation, They were randomized into 2 groups. Patients in group SF received Shenfu 100 mL/h to use pump-infusion within 1 h before anesthesia induction. While patients in group NS received 100 mL 0.9% NaCL at the same time. Blood samples were taken from jugualar bulb venous and radial artery before infusion (T1), after opening the dura (T2) and 5 min after opening the dura (T3) for blood gas analysis, and the oxygen content of artery (CaO2), oxygen content of jugular venous (CjvO2) and cerebral metabolic rate for oxygen (CEO2) were calculated. [Results] Compared with NS group, SBP and CEO2 were stable in group SF after infusion during decompression craniotomy, showed more significantly different between two groups (P <0.05 or P <0.001). SjvO2 and CjvO2 were better in SF group than NS group (P <0.05). DBP, HR, SaO2, CaO2 and PaCO2 showed no significant difference between two groups (P >0.05). [Conclusions] To some degree, Shenfu injection may be improved in patients with traumatic brain injury during decompression craniotomy, and maintain the balance cerebral oxygen delivery and consumption.更多还原