| 摘要: |
| 目的：探讨儿童脓毒症脑病的有效对症支持疗法。方法：选取2018年1月至2019年5月我院ICU收治的脓毒症脑病患儿100例，采用随机数表法分为观察组和对照组各50例。对照组患儿接受纳洛酮治疗，观察组患儿接受纳洛酮联合右美托咪定治疗，均持续治疗7 d。观察两组患儿治疗前（T0）、治疗1 d（T1）、治疗3 d（T2）的S100β蛋白水平、脑氧代谢指标如动脉血氧饱和度（rSO2）、颈内静脉血氧饱和度（SjvO2）、颈内静脉血氧含量差（Da-jvO2）、脑氧代谢率（CERO2）以及治疗前后的危重症系统评分（APACHEⅡ）、Glasgow评分。结果：两组患儿T0时的血清S100β、rSO2、SjvO2、Da-jvO2、CERO2水平比较，差异均无统计学意义（P均>0.05）；观察组T1、T2、T3的S100β、Da-jvO2、CERO2水平低于对照组，rSO2、SjvO2水平高于对照组（P均<0.05）。观察组治疗后APACHEⅡ评分低于对照组，Glasgow评分高于对照组（P均<0.05）。结论：纳洛酮联合右美托咪定能降低儿童脓毒症脑病的S100β蛋白水平，维持脑氧代谢平衡。 |
| 关键词: 纳洛酮 右美托咪定 儿童 脓毒症脑病 S100β蛋白 脑氧代谢 |
| DOI：doi:10.13407/j.cnki.jpp.1672.108X.2020.12.007 |
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| 基金项目:江苏省国际交流支撑计划,编号JSH鄄2011鄄018;江苏省卫计委资助项目,编号Y2015013 |
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| Effects of Naloxone Combined with Dexmedetomidine Sedation on S100β Protein and Oxygen-Brain Metabolism in Children with Septic Encephalopathy |
| Wang Yaqiong, Lu Zhaofeng |
| ((The First Affiliated Hospital of Henan University of Science and Technology, Henan Luoyang 471000, China)) |
| Abstract: |
| Objective: To investigate the effective symptomatic support therapy for children with septic encephalopathy. Methods: Totally 100 children with septic encephalopathy admitted into ICU of our hospital from Jan. 2018 to May 2019 were extracted to be divided into the observation group and the control group via the random number table, with 50 cases in each group. The control group received naloxone, while the observation group was given naloxone combined with dexmedetomidine, both groups were treated for 7 d. The levels of S100β protein, cerebral oxygen metabolism indicators such as regional cerebral oxygen saturation (rSO2), internal jugular venous blood oxygen saturation (SjvO2), internal jugular venous oxygen content difference (Da-jvO2), cerebral oxygen metabolism rate (CERO2) and acute physiology before treatment (T0), after treatment of 1 d (T1), after treatment of 3 d (T2) and chronic health evaluation Ⅱ (APACHEⅡ), Glasgow score before and after treatment of two groups were observed. Results: There was no statistically significant difference in serum S100β, rSO2, SjvO2, Da-jvO2 and CERO2 levels at T0 between two groups (P>0.05). The levels of S100β, Da-jvO2 and CERO2 in the observation group at T1, T2 and T3 were lower than those in the control group, and the levels of rSO2 and SjvO2 in the observation group were higher than those in the control group (P<0.05). After treatment, the APACHEⅡ score of the observation group was lower than that of the control group, and the Glasgow score was higher than that of the control group (P<0.05). Conclusion: Naloxone combined with dexmedetomidine can reduce the level of S100β protein in children with septic encephalopathy and maintain the balance of cerebral oxygen metabolism. |
| Key words: naloxone dexmedetomidine children septic encephalopathy S100β protein cerebral oxygen metabolism |
