低氧死腔通气与屏气试验对脑血管反应性测试的对比观察

发布时间：2018-02-22 01:43

本文关键词： 脑血管反应性低氧死腔通气屏气试验 TCD　出处：《临床神经病学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的通过低氧死腔通气与屏气试验的对比,探讨低氧死腔通气在血管运动反应性(VMR)测试中的应用前景。方法选择门诊或住院进行TCD检测的患者,先后进行屏气试验及低氧死腔通气,并计算其VMR进行对比分析。记录患者的配合程度、耐受情况及不良反应。结果入组35例患者,屏气试验有7例(20%)患者因配合不佳退出研究,而低氧死腔通气仅有2例(5.71%)因配合不佳退出,最终26例患者纳入研究。屏气试验除屏气后代偿性呼吸增快外,基本没有不良反应;低氧死腔通气不良反应主要表现在通气末期呼吸频率加快加深,心率增快,脉氧轻度下降,但停止通气后很快恢复。纳入研究的26例患者在屏气试验前及低氧死腔通气前的平均血流速度差异无统计学意义。在屏气试验后及低氧死腔通气后平均血流速度均明显升高,且二者相关性良好(P0.001),低氧死腔通气的VMR值明显高于屏气试验(P0.001)。屏气试验平均血流速度曲线表现为轻度下降后迅速升高的单向曲线,而低氧死腔通气则表现为短时下降后较缓上升的曲线,有一平台期。结论低氧死腔通气可以有效改善患者不能配合的影响,避免缺氧造成不耐受,所测定的VMR值较屏气试验更加精确,并且能反应血管的最大反应能力,具有更高的临床应用价值。
[Abstract]:Objective to explore the application prospect of hypoxic dead chamber ventilation in VMRs by comparing hypoxic dead chamber ventilation with breath-holding test. Breath holding test and hypoxic dead chamber ventilation were carried out successively, and their VMR were calculated for comparative analysis. The degree of cooperation, tolerance and adverse reactions of the patients were recorded. Results 35 patients were enrolled in the study, 7 patients in the breath-holding test, and 7 patients withdrew from the study because of poor cooperation. However, only 2 cases of hypoxic dead chamber ventilation withdrew due to poor coordination, and 26 patients were included in the study. Except for the compensatory respiratory acceleration after breath-holding, there was basically no adverse reaction in the breath-holding test. The main adverse effects of hypoxic dead chamber ventilation were the acceleration and deepening of respiratory rate, the increase of heart rate and the slight decrease of pulse oxygen at the end of ventilation. However, there was no significant difference in the mean blood flow velocity before the breath holding test and before the hypoxic dead chamber ventilation in the 26 patients who were enrolled in the study. The mean blood flow velocity increased significantly after the breath-holding test and after the hypoxic dead chamber ventilation. The VMR value of hypoxic dead chamber ventilation was significantly higher than that of breath-holding test (P0.001). The mean blood flow velocity curve of breath-holding test was a one-way curve that increased rapidly after a slight decrease. However, hypoxic dead chamber ventilation showed a slowly rising curve after a short period of decline. Conclusion hypoxic dead chamber ventilation can effectively improve the effect that patients can not cooperate and avoid intolerance caused by hypoxia. The measured VMR value is more accurate than the breath-holding test, and can reflect the maximum response ability of the blood vessel, so it has higher clinical application value.
【作者单位】：南京医科大学附属淮安第一医院神经内科;
【分类号】：R743

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