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我院采用过度通气降低颅内压成功抢救脑疝患儿1例,现报告如下。患儿,男,8岁,体重23kg。因呕吐、嗜睡6天,渐昏迷19小时入院、当地医院脑脊液检查示压力高,其它正常。脑电图示:中度弥漫性改变。入院体检:T38℃、P160次/分、R24次/分,BP14/8kPa、浅昏迷、瞳孔直径2mm,双侧瞳孔等大等圆,对光反应稍迟钝,颈抵抗,心肺(-),四肢肌张力高,双侧巴氏证(+),入院后给予20％甘露醇120ml q6h静推,速尿20mg q6h静推,地塞米松5mg q12h静脉点滴,同时用能量合剂,次日下午6时患儿抽搐频繁,昏迷加深,紫绀,双侧瞳孔不等大,右侧0.4mm,左侧0.2mm,对光反应消失、呼吸不规则、心率56次/分,心音低钝、血气示:pH7.31、PaCO_26.9kPa)PaO_26.7kPa、BE1.8,
Our hospital used hyperventilation to reduce intracranial pressure successfully rescue children with cerebral hernia in 1 case, are as follows. Children, male, 8 years old, weighing 23kg. Due to vomiting, lethargy for 6 days, gradually coma 19 hours admission, local hospital cerebrospinal fluid examination showed high pressure, the other normal. EEG shows: moderate diffuse changes. Admission physical examination: T38 ℃, P160 beats / min, R24 beats / min, BP14 / 8kPa, shallow coma, pupil diameter 2mm, bilateral pupil and other large round, slightly slow reaction to light, Muscle tension, bilateral Paz syndrome (+), after admission to give 20% mannitol 120ml q6h push, furosemide 20mg q6h push, dexamethasone 5mg q12h intravenous drip, while using energy mixture, the next day at 6 pm Children with frequent convulsions, coma deepened, cyanosis, bilateral pupil ranging from the right side of the 0.4mm, left 0.2mm, disappeared reaction to light, irregular breathing, heart rate 56 beats / min, low heart sound, blood gas showed: pH7 .31, PaCO_26.9 kPa) PaO_26.7 kPa, BE1.8,