简介:Objective: Toexploretheregulationofearlybraintissuemetabolicchangingafterbraininjuriesandtheclinicalsignificance. Methods: Therewere17patientswithbraininjuries.EarlydirectmonitoringofPtiO2,PtiCO2,pHandbraintemperature,dynamicobservationoftherelationbetweenvariousparametersandclinicsafterbraininjurieswereperformed. Results: EarlychangesofPtiO2,PtiCO2andpHwerecloselycorrelatedwithoutcome.ThedeathrateobviouslyincreasedwhenPtiO2wascontinuouslylowerthan9mm?Hgwithin24hoursafterinjuries.Secondarybraininjuryprolongedandaggravatedbraintissuemetabolicdisturbance.Whenintracerebralpressurewasover30mm?HgPtiO2begantodecrease.Thebraintemperatureinbraindeathpatientswasevidentlylowerthanaxillarytemperature. Conclusions: ThedirectmonitoringofPtiO2,PtiCO2,pHandbraintemperatureissafeandaccurateandcanfindearlyanoxiadamagetobraintissueandprovidereliablebasisforclinicaltherapy.Ithasaninstructivesignificanceinselectingandstudyinganewtreatmentmethodinbraininjuries.Anditcanbetakenasacriterioninclinicaljudgingbraindeaths.
简介:例1:女性,70岁,因反复发作性眩晕二月余于97年11月11日入院。体检:姿位性眼震(+),两侧颈肌压痛(+),Jackson征(+).双肩外展试验(+)。血流变检测提示:血浓度、聚度及粘度增高,甘油三酯高(2.9mmol/L)。颅脑MRI检查提示脑缺血性改变。拟诊“(1)慢性脑供血不足Ⅰ型,(2)颈椎病”。入院后给予脑活素(奥地利依比威药厂,10ml/安瓿)20ml加入5%GS250ml中静滴,1次/日,未给予其它静脉用药。患者静滴前3天无不适,第4天液体输入约一半时,患者出现发冷,发抖,无胸闷及心慌等,体检未见皮疹。立即给予地塞米松5mg静注,渐恢复。患者既往曾多次应用脑活素,均无类似情况出现。