甲基泼尼松龙短期冲击对心肺复苏后患儿脑血流的影响(1)
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[摘要] 目的：探讨应用甲基泼尼松龙对心肺复苏后患儿进行短期冲击对其脑血流动力学的影响。方法：以大脑中动脉(MCA)与颈内动脉颅外段(EICA)为参照血管，应用经颅多普勒超声(TCD)观察27例复苏后患儿脑血流变化的趋势及首剂静脉使用甲基泼尼松龙后相应指标的变化。依据舒张期血流将患儿分为两组，A组为舒张期血流正向(12例)，B组为舒张期血流消失或反流(15例)。结果：A组治疗前后MCA和EICA的收缩期峰流速(Vp)、舒张期流速(Vd)、平均流速(Vm)、脉动指数(PI)无明显改变(P>0.05)；B组用药后MCA的Vd、Vm、Vp增加，PI降低(P<0.05)，EICA的Vd增加(P<0.05)，Vm、Vp 、PI无明显变化(P>0.05)，患儿成活率高。结论：脑损害较轻的患儿应用甲基泼尼松龙短期冲击治疗可改善脑灌注，而对于脑损害严重的患儿短期甲基泼尼松龙冲击治疗对于脑灌注的调节作用不大。
[关键词] 甲基泼尼松龙；心肺复苏；脑血流
[中图分类号] R743[文献标识码]A [文章编号]1673-7210(2010)10(c)-038-03
Influence of methylprednisolone short-term pulse therapy on cerebral blood flow after cardiopulmonary resuscitation in children
PANG Yin
(Department of Pediatrics, the First People′s Hospital of Ji′ning City, Shandong Province, Ji′ning 272011, China)
[Abstract] Objective: To investigate the influence of methylprednisolone short-term pulse therapy on cerebral blood flow after cardiopulmonary resuscitation in children. Methods: Middle cerebral artery (MCA) and extracranial internal carotid artery (EICA) as the reference vessel, using transcranial Doppler ultrasound (TCD), 27 cases were observed in children with cerebral blood flow after recovery trend and the change of indices on a splash of the first dose of intravenous after the corresponding methylprednisolone. Patients were randomly divided into group A for the diastolic flow positive (12 cases), group B, diastolic flow disappeared or regurgitation (15 cases). Results: Group A before and after treatment, there was no significant change for MCA, EICA, Vp, Vd, Vm, PI (P>0.05); group B after treatment, MCA Vd, Vm, Vp increase, PI decreased (P<0.05), EICA of Vd increased (P<0.05), there was no significant change for Vm, Vp, PI (P>0.05), children with high survival rate. Conclusion: Children with slight brain damage to apply methylprednisolone short-term pulse therapy can improve cerebral perfusion, but for children with serious brain damage, methylprednisolone short-term pulse therapy is not to be big regarding for cerebral perfusion ......
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