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目的探讨盐酸戊乙奎醚对心肺复苏术后患者的脑氧供需失衡和神经功能状况的影响。方法选择40例心肺复苏初步成功的病人,采用临床神经功能综合评分(NFCS)对其神经功能状况进行评定,试验组(25例)给予盐酸戊乙奎醚4mg/24h,微量泵持续泵入,首量加倍;对照组(15例)未使用盐酸戊乙奎醚,其余治疗方案同试验组。观察期间监测病人动脉血氧含量(CaO2),颈内静脉血氧饱和度(SjvO2)、氧含量(CjvO2)及动脉血乳酸盐含量(ABL)和颈内静脉血乳酸盐含量(JVBL),并计算脑氧摄取率(CERO2),桡动脉-颈内静脉血乳酸盐差值(DLA-V)。结果在心肺复苏术后第72h,NFCS评分试验组明显较对照组高(P<0.01);与对照组相比,在48、72h两个时段,试验组氧代谢指标CjvO2、SjvO2、ABL、JVBL、DLA-V显著降低,CERO2显著增高(P<0.05或P<0.01)。结论盐酸戊乙奎醚可改善心肺复苏术后患者的脑组织缺氧和神经功能状况。
Objective To investigate the influence of penehyclidine hydrochloride on cerebral oxygen supply and demand imbalance and neurological status after cardiopulmonary resuscitation. Methods Forty patients with initially successful cardiopulmonary resuscitation (CPR) were enrolled in this study. The neurological status was assessed by clinical neurological functional comprehensive score (NFCS). The experimental group (n = 25) received penehyclidine hydrochloride 4 mg / The first doubled; control group (15 cases) did not use penehyclidine hydrochloride, the rest of the treatment program with the experimental group. During the observation period, the arterial oxygen content (CaO2), the internal jugular vein oxygen saturation (SjvO2), the oxygen content (CjvO2) and the arterial blood lactate content (ABL) and the jugular vein blood lactate content (JVBL) , And calculate the cerebral oxygen uptake rate (CERO2), radial artery - jugular vein blood lactate difference (DLA-V). Results Compared with the control group, the experimental group had significantly higher levels of CjvO2, SjvO2, ABL, JVBL in the experimental group than those in the control group at 72 h and 72 h after cardiopulmonary resuscitation (P <0.01) , DLA-V decreased significantly and CERO2 increased significantly (P <0.05 or P <0.01). Conclusion Penehyclidine hydrochloride can improve the brain hypoxia and neurological status in patients after cardiopulmonary resuscitation.