过度换气综合征的急诊护理措施分析

目的：探究对过度换气综合征患者采取的急诊护理措施以及其临床护理效果。方法选自广东医学院附属东莞市石龙博爱医院2010年1月～2012年1月收治的过度换气综合征患者共100例,随机均分为对照组与观察组（n=50）。对照组患者接受常规的护理措施,观察组患者则接受针对性的急诊护理措施,对比2组患者的临床治疗效果。结果观察组患者接受治疗后2 h内得以缓解的患者有48例,2例患者需留院观察,24 h后出院;对照组患者接受治疗后2 h内得以缓解的患者有42例,5例患者需留院观察,3例患者需住院治疗,相对于对照组患者,观察组患者护理效果更具有优越性,差异有统计学意义（P＜0.05）。结论对过度换气综合征应用急诊护理措施,具有重要的临床意义与价值。     

Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study

The pulmonary effects of hyperventilation following infusion of sodium salicylate into the cisterna magna was studied in 16 spontaneously breathing adult sheep. We found a fall in PaO₂, a decrease in the static compliance of the respiratory system, abnormal chest roentgenographic films, and grossly abnormal lungs following 3.5 to 13 h of hyperventilation. A control group of 15 sheep (10 sheep similarly injected with sodium salicylate, but then sedated and paralyzed and ventilated at normal tidal volume and respiratory rate on a mechanical ventilator, and 5 sheep infused with saline alone and breathing spontaneously) showed no pulmonary or arterial blood gas abnormalities. We conclude that prolonged hyperventilation under the conditions of this experiment precipitated events that resulted in acute lung injury.     

Effects of hydration and hyperventilation on cortical complexity

The effects of hydration and hyperventilation on cortical complexity were investigated in a sample of 19 healthy volunteers in a double-blind placebo design using magnetoencephalographic recordings. The subjects were asked to abstain from the intake of liquids 18 h before the study. Spontaneous magnetoencephalograms (MEG) were recorded before and after drinking 750 ml water (WAT group: nine subjects) or saline solution (SAL group: ten subjects) with eyes closed and open and during hyperventilation (HV) with eyes open. The MEG data were analysed using both linear (spectral power) and non-linear (pointwise dimension and largest Lyapunov exponent) algorithms. The prediction that intake of water, because of induced cell swelling, will lead to an increased synchronization and a decreased complexity of the spontaneous MEG during hyperventilation was confirmed. Hyperventilation following the drinking condition produced an increase in all power spectra with a stronger increase of delta and theta power after drinking of water. This synchronization of spontaneous MEG is accompanied by a general significant decrease of cortical complexity, especially after water drinking. Moreover, cortical complexity was inversely related to delta and theta power and partly also to alpha power. The SAL and WAT groups showed different relations between alpha power and dimensional complexity during HV: whereas in the SAL group the correlations between these measures became more negative during HV, they reversed in the WAT group to become positive. The synchronizing effect of hyperventilation, leading to a decrease of cortical complexity, is related in the SAL group to delta, theta and alpha power, whereas in the WAT group only delta and theta activity contribute to a reduction of cortical complexity. Electronic Publication     

Reduced hypoxic ventilatory response with preserved blood oxygenation in yoga trainees and Himalayan Buddhist monks at altitude: evidence of a different adaptive strategy?

Yoga induces long-term changes in respiratory function and control. We tested whether it represents a successful strategy for high-altitude adaptation. We compared ventilatory, cardiovascular and hematological parameters in: 12 Caucasian yoga trainees and 12 control sea-level residents, at baseline and after 2-week exposure to high altitude (Pyramid Laboratory, Nepal, 5,050 m), 38 active lifestyle high-altitude natives (Sherpas) and 13 contemplative lifestyle high-altitude natives with practice of yoga-like respiratory exercises (Buddhist monks) studied at 5,050 m. At baseline, hypoxic ventilatory response (HVR), red blood cell count and hematocrit were lower in Caucasian yoga trainees than in controls. After 14 days at altitude, yoga trainees showed similar oxygen saturation, blood pressure, RR interval compared to controls, but lower HVR (−0.44 ± 0.08 vs. −0.98 ± 0.21 l/min/m/%SaO₂, P < 0.05), minute ventilation (8.3 ± 0.9 vs. 10.8 ± 1.6 l/min, P < 0.05), breathing rate (indicating higher ventilatory efficiency), and lower red blood cell count, hemoglobin, hematocrit, albumin, erythropoietin and soluble transferrin receptors. Hypoxic ventilatory response in monks was lower than in Sherpas (−0.23 ± 0.05 vs. −0.63 ± 0.09 l/min/m/%SaO₂, P < 0.05); values were similar to baseline data of yoga trainees and Caucasian controls, respectively. Red blood cell count and hematocrit were lower in monks as compared to Sherpas. In conclusion, Caucasian subjects practicing yoga maintain a satisfactory oxygen transport at high altitude, with minimal increase in ventilation and with reduced hematological changes, resembling Himalayan natives. Respiratory adaptations induced by the practice of yoga may represent an efficient strategy to cope with altitude-induced hypoxia.     

间接激发试验诊断运动诱发性支气管痉挛

运动诱发性支气管痉挛（exercise-induced bronchoconstriction,EIB）是由运动诱发的急性短暂的气道缩窄。在运动员中的发病率约3％～13％,诊断EIB需要肺功能下降的客观依据,间接气道激发试验是常用于诊断EIB的肺功能检查,本文就一些国际上认可的间接气道激发试验的方法及判断标准做一综述。     

Effect of hyperventilation on brain tissue oxygen pressure, carbon dioxide pressure, pH value and intracranial pressure during intracranial hypertension in pigs

ＨＤｅｐａｒｔｍｅｎｔｏｆＮｅｕｒｏｓｕｒｇｅｒｙ ,ＣｈａｎｇｚｈｅｎｇＨｏｓｐｉｔａｌ,ＳｅｃｏｎｄＭｉｌｉｔａｒｙＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ ,Ｓｈａｎｇｈａｉ 2 0 0 0 0 3,Ｃｈｉｎａ (ＢａｏＹＨ ,ＪｉａｎｇＪＹ ,ＺｈｕＣ ,ＬｕＹＣ ,ＣａｉＲＪａｎｄＭａＣＹ)ｙｐｅｒｖｅｎｔｉｌａｔｉｏｎ (ＨＶ )ｈａｓｂｅｅｎｗｉｄｅｌｙｕｓｅｄｔｏｄｅｃｒｅａｓｅｔｈｅｉｎｔｒａｃｒａｎｉａｌｐｒｅｓｓｕｒｅ (ＩＣＰ)ｉｎｔｈｅｐａｔｉｅｎｔｓｗｉｔｈｓｅｖｅｒｅｔｒａｕｍａｔｉｃｂｒａｉｎｉｎｊｕｒｙ…     

过度换气综合征致手足搐搦的处置

目的：探索葡萄糖酸钙与安定对过度换气所致手足搐搦的疗效;方法：静脉注射10％葡萄糖酸钙注射液10ml,肌肉注射安定注射液10mg,观察15min内的手足搐搦缓解情况,并判定疗效;结果：显效23例,有效6例,无效1例;结论：应用葡萄糖酸钙和安定可迅速有效地缓解手足搐搦。     

脑氧代谢监测在脑外伤术中过度通气时的价值

目的观察术中过度通气对急性颅脑外伤患者氧代谢的影响,探讨脑氧代谢监测的价值。方法 36例急性颅脑外伤患者,手术中分别于正常通气（PETCO25.0 Kpa）、轻度（PETCO25.0~4.0 Kpa）、中度（PETCO23.5 Kpa）、重度（PETCO23.0 Kpa）过度通气并稳定20 min后同步采集外周动脉和颈静脉球部血样行血气分析,监测SjvO2并计算Da-jvO2。结果随着PETCO2的降低,SjvO2下降,Da-jvO2增加,在中度过度通气时均在安全范围,但至重度过度通气时,有10例SjvO2低于50%,24例Da-jvO2高于9 ml%,显示部分患者脑缺氧。结论脑氧代谢监测可指导脑外伤患者术中过度通气,重度过度通气时可导致脑氧供需失衡,故在颅脑手术麻醉中应避免重度过度通气。