开颅术中过度通气对哌库溴铵时效的影响

目的 :研究过度通气对哌库溴铵时效的影响。方法 :选择无神经肌肉疾患 ,ASAⅠ～Ⅱ级择期神经外科手术患者 2 4例 ,随机分成对照组 (A组 ,n =12 )和过度通气组 (B组 ,n =12 ) ,术中控制呼吸 ,维持PaCO2 分别大于或小于 35mmHg。用加速度仪监测拇内收肌收缩反应。观察两组哌库溴铵 0 1mg/kg时效差异。结果 :A、B组起效时间分别为 3 2 1± 0 49分钟和 3 0 8± 0 2 3分钟 ,无显著性差异 ;临床时效分别为 10 4 6 7± 7 33分钟和 87 0 8± 5 45分钟 ,P <0 0 5 ;恢复指数分别为 2 6 2 5± 2 85分钟和 2 3 75± 2 73分钟 ,无显著性差异。结论 :过度通气可使哌库溴铵临床时效缩短 ,但起效时间和恢复指数无明显差异     

过度换气综合征儿童的气质类型分析

目的 探讨过度换气综合征患儿的气质类型.方法 选择56例过度换气综合征患儿(过度换气综合征组)和56例健康儿童(对照组).采用中国学龄儿童气质问卷(CSTS)进行测查,比较两组儿童的气质类型构成和气质维度得分.结果 两组儿童气质类型构成间差别有统计学意义(P＜0.01);两组儿童气质维度中的活动水平、节律性、适应性、心境、注意分散得分间差别均有统计学意义(P＜0.01).结论 过度换气综合征患儿的气质类型以中间近麻烦型和发动缓慢型为主,较健康儿童活动水平高、节律性差、适应性慢、注意力易分散、心境消极.     

Emotional responding to hyperventilation as a predictor of agoraphobia status among individuals suffering from panic disorder

Some data suggest that panic patients with extensive agoraphobia (PDA) display more intense respiratory distress during their panic attacks than Panic disorder (PD) patients. However, no studies have determined if PDA patients also show heightened sensitivity to a respiratory challenge compared to PD patients. The current study examined the differential emotional responding to hyperventilation among PDA patients, PD patients, and a non-clinical group with a history of panic attacks. Response to hyperventilation challenge did not distinguish non-clinical panickers from panic patients; however, behavioral tolerance to hyperventilation challenge significantly predicted agoraphobia status among panic disorder patients, even after controlling for demographic and clinical status variables.     

Respiratory pattern in a rat model of epilepsy

PURPOSE: Apnea is known to occur during seizures, but systematic studies of ictal respiratory changes in adults are few. Data regarding respiratory pattern defects during interictal periods also are scarce. Here we sought to generate information with regard to the interictal period in animals with pilocarpine-induced epilepsy. METHODS: Twelve rats (six chronically epileptic animals and six controls) were anesthetized, given tracheotomies, and subjected to hyperventilation or hypoventilation conditions. Breathing movements caused changes in thoracic volume and forced air to flow tidally through a pneumotachograph. This flow was measured by using a differential pressure transducer, passed through a polygraph, and from this to a computer with custom software that derived ventilation (VE), tidal volume (VT), inspiratory time (TI), expiratory time (TE), breathing frequency (f), and mean inspiratory flow (VT/TI) on a breath-by-breath basis. RESULTS: The hyperventilation maneuver caused a decrease in spontaneous ventilation in pilocarpine-treated and control rats. Although VE had a similar decrease in both groups, in the epileptic group, the decrease in VE was due to a significant (p < 0.05) increase in TE peak in relation to that of the control animals. The hypoventilation maneuver led to an increase in the arterial Paco2, followed by an increase in VE. In the epileptic group, the increase in VE was mediated by a significant (p < 0.05) decrease in TE peak compared with the control group. Systemic application of KCN, to evaluate the effects of peripheral chemoreception activation on ventilation, led to a similar increase in VE for both groups. CONCLUSIONS: The data indicate that pilocarpine-treated animals have an altered ability to react to (or compensate for) blood gas changes with changes in ventilation and suggest that it is centrally determined. We speculate on the possible relation of the current findings on treating different epilepsy-associated conditions.     

Hyperventilation in asthma: A validation study of the Nijmegen Questionnaire – NQ

Introduction: The Nijmegen questionnaire (NQ) has previously been used for screening the hyperventilation syndrome (HVS) in asthmatics. However, no validity study has been reported so far. Objective: To examine the validity and reliability of the NQ in asthma patients and identify the prevalence of HVS. Methods: The NQ (n?=?162) was examined for translation, construct, cross-sectional and discriminant validity as well as for internal consistency and test–retest reliability. Results: Principal component analysis and exploratory factor analysis revealed a single factor solution with 11 items and 58.6% of explained variability. These 11 NQ items showed high internal consistency (Cronbach's alpha?=?0.92) and test–retest reliability (IR?=?0.98). Higher NQ scores were found in the following subgroups: women versus men (p?p?p?p?2 (ETCO₂) ≤35 versus >35?mmHg (p?17 discriminated the participants with regard to the presence of HVS. The NQ showed 92.73% sensitivity and 91.59% specificity. The total NQ score was found significantly correlated with ETCO₂ (r?=??0.68), RR (r?=?0.66) and BHT (r?=??0.65). The prevalence of HVS was found 34%. Conclusion: The NQ is a valid and reliable questionnaire for screening HVS in patients with stable mild-to-moderate asthma.     

Quatre approches des processus inconscients : l’expérience de mort imminente,la pneumanalyse,la méditation,la psychose aiguë

The unconscious is not conscious ! Thus, there are only partial events obtained as a result of specific psychotherapeutic approaches: the dream, the parapraxis, the transference in Freud, the “relaxation” in Ferenczi, the symbolism in Jung, the deconstruction of speech in Lacan. Recent decades have proposed new pathways: the scientific study of “near-death experiences”, hyperventilation exercises, and meditation, particularly. These three experiences reveal the same course with three formal processes that occur in succession: “the essence of energy” (close to the Freudian unconscious), “the nature of the spirit” and “the intimate of the relationship” (close to Jung's collective unconscious). This formalization of unconscious processes leads to three major developments: the explanation of the progress of acute psychosis.     

外伤后急性大脑半球肿胀诊治分析（附182例报告）

目的探讨外伤后急性大脑半球肿胀(ACHS)的临床特点,CT、MRI影像学表现和治疗效果。方法对我院近8年来收治的182例ACHS患者采取去大骨瓣减压术治疗69例,过度通气 去大骨瓣减压术治疗113例。结果去大骨瓣减压术治疗的69例中,死亡20例,重残10例,中残9例,恢复良好30例;过度通气 去大骨瓣减压术治疗的113例中,死亡23例,重残14例,中残23例,恢复良好53例。结论对于ACHS患者,应及时采取有效治疗措施。有效地控制颅内压增高,建立足够的换气和循环通道,改善脑灌注压,是减轻继发性脑损害,提高抢救成功率,降低致残率的关键。     

Stress-induced changes in respiratory quotient,energy expenditure and locomotor activity in rats: effects of midazolam

Changes in O₂ consumption, CO₂ production and locomotor activity were examined in rats exposed to (1) brief footshock, (2) an aversive conditioned stimulus (CS) predicting footshock, or (3) the anxiogenic drug FG-7142. Respiratory quotient (RQ=CO₂ produced/O₂ consumed) and energy expenditure [EE=O₂ consumed (364+113RQ)] were derived to give an estimate of the energy substrate (fat, carbohydrate or protein) being utilised and total substrate oxidation respectively. In experiment 1, footshock (4 × 5 s 0.6 mA shocks over 2 min) produced an immediate increase in RQ, EE and activity. The RQ and EE effects were attenuated by the benzodiazepine midazolam (1 mg/kg). In experiment 2, an aversive CS, consisting of flashing light and buzzer that had 24 h earlier been repeatedly paired with footshock (20 × 5 s 0.6 mA shocks) caused a pronounced drop in RQ, an increase in EE and locomotor activity suppression. The effects of the aversive CS on RQ and EE were reversed by midazolam (1 mg/kg). In experiment 3, FG-7142 (10 mg/kg) produced a steep drop in RQ that persisted for at least 2 h and which was reversed by midazolam (1 mg/kg) and delayed by the benzodiazepine antagonist RO 15-1788 (10 mg/kg). FG-7142 also tended to inhibit EE and locomotor activity, but these effects did not reach statistical significance. Overall, these data show that stress causes profound alterations in RQ, EE and activity and that the pattern of change in these parameters differs with the nature of the stressor involved.Parts of this paper were presented at the joint meeting of the British Psychopharmacology Society and European Society for Behavioural Pharmacology. Cambridge, U.K. August 1992.     

On octanoic acid-induced hyperventilation — implications for hepatic encephalopathy and Reye's syndrome

Medium chain fatty acid sodium octanoate was infused into rabbits as a 0.2 M solution over 4 h resulting in blood and brain octanoate levels of 200-800 mumol/l. The infused animals developed marked hyperventilation leading to a mild respiratory alkalosis. Additionally, octanoate infusion brought about hyperammonemia and hyperlactate acidemia. Another group of rabbits also infused with octanoate but pretreated with indomethacin (10 mg/kg b.wt.) developed neither hyperventilation nor hyperammonemia. Therefore, the conclusion made was that octanoate causes the above mentioned disorders through stimulation of prostaglandin synthesis and especially the PGE2 synthesis. Patients with hepatic encephalopathy and Reye's syndrome have elevated levels of plasma octanoate. The present study suggests that octanoate might be the cause for both the hyperventilation and hyperammonemia observed in patients with hepatic encephalopathy and Reye's syndrome.