摘要
目的 探讨Neurotrend 7脑组织氧代谢监测仪在神经外科的应用价值。方法 对 2 0例在全麻下行开颅术的患者术中持续进行脑组织氧代谢监测 ,观察 12例颅脑损伤患者在血肿清除前后和 8例动脉瘤夹闭术中临时阻断载瘤动脉时脑组织氧分压 (PbtO2 )、脑组织二氧化碳分压 (PbtCO2 )、脑组织pH值 (pHbt)的变化。结果 ① 12例颅脑损伤患者在血肿清除后 ,PbtO2 、pHbt分别从 (16± 7)mmHg、6 .99± 0 .12增加到 (2 8± 6 )mmHg、7.11± 0 .0 9(P <0 .0 5 ) ,PbtCO2 从 (5 9± 6 )mmHg下降到(46± 5 )mmHg(P <0 .0 5 ) ;②载瘤动脉临时阻断后 ,PbtO2 、pHbt分别从 (2 4± 6 )mmHg、7.12± 0 .0 5下降到 (13± 4 )mmHg、7.0 4± 0 .0 6 (P <0 .0 5 ) ,PbtCO2 从 (45± 6 )mmHg升高到 (5 6± 4 )mmHg(P <0 .0 5 )。结论 脑组织氧代谢监测是一种安全、可靠的监测手段 ,能直接动态反映脑组织的病理生理变化 ,及时发现脑组织缺血缺氧 ,以指导治疗。
Objective To investigate the use of Neurotrend-7 in neurosurgical patients.Methods Twenty patients undergoing cran iotomy with general anesthesia were monitored continuously by Neurotrend-7 with a multiparameter sensor inserted into the brain which measured brain tissue PO 2(P btO 2), PCO 2(P btCO 2), pH(pH bt) an d the temperature. The changes of P btO 2, P btCO 2 , and pH bt after removal of a traumatic intracranial hematoma were also studie d in twelve patients with traumatic brain injury . P btO 2, P btC O 2 and pH bt before and during temporary occlusion in eight patients with aneurysms were compared.Results ①Removal of intracranial hematoma in twelve patients with traumatic brain injury (TBI) resulted in a sig nificant increase in P btO 2 and pH bt , from (16±7) mmHg and 6. 95±0.19 to (28±6) mmHg and 7.11±0.09 respectively(P<0.05), and decre ase in P btCO 2 , from (59±6)mmHg to (46±5) mmHg (P<0.05);②D uring temporary occlusion, P btO 2 and pH bt decreased from (24± 6) mmHg and 7.12±0.05 to (13±4) mmHg and 7.04±0.06 respectively( P<0.05 ). P btCO 2 increased from (45±6) to (56±4)mmHg(P<0.05). Conclusion Continuous monitoring of P btO 2, P btCO 2, pH bt and brain temperature by Neurotrend-7 is a safe and reliable method. It may give valuable informations about the metabolic status o f cerebral tissues, allowing direct regional evaluation of pathophysiology of ce rebral tissues and early detection of secondary insults, then provide rapid and dependable titration of common therapeutic modality.
出处
《中华神经外科疾病研究杂志》
CAS
2005年第1期28-30,共3页
Chinese Journal of Neurosurgical Disease Research
关键词
脑组织氧分压
脑组织二氧化碳分压
脑组织pH值
监测
Brain tissue oxygen tension
Brain tissue carbon dioxide tension
Brain t issue pH
Monitoring
