摘要
目的 :探讨颅脑损伤后脑氧代谢变化及其意义。方法 :选择重型脑损伤 15例 ,对照组 10例。通过颈内静脉插管采血 ,观察颈静脉血氧饱和度 (Sj O2 )、脑氧摄取 (CEO2 )和脑动静脉氧差 (AVDO2 ) ,并分析其与颅内压的关系。结果 :伤后第 1日 Sj O2 下降 ,CEO2 和 AVDO2 升高。伤后第 2、3和 4日 Sj O2 升高 ,CEO2 和 AVDO2 下降。颅内压轻、中度增高时 ,Sj O2 升高 ,CEO2 和 AVD结论 :重型脑损伤后 2 4小时内存在脑缺氧、缺血 ,伤后第 2～ 4日为脑氧合过度、脑充血。伤后颅内压重度增高伴随脑缺氧、缺血 ,但轻、中度颅内压增高不一定引起脑缺氧。
Objective:To investigate the changes in cerebral oxygen metabolism following head injury and its relationship with intracranial pressure (ICP).Methods:15 patients with acute severe head injury were studied,and 10 healthy objects were used as the control.By using a technique of jugular catheterization and blood sampling,the changes in oxygen saturation of jugular blood (SjO 2),cerebral extraction of oxygen (CEO 2) and cerebral arteriovenous difference of oxygen(AVDO 2) were observed.Furthermore,the relationship of these parameters with ICP was analyzed.Results:On the first day postinjury,SjO 2 decreased,CEO 2 and AVDO 2 increased;on the secondfourth day,SjO 2 increased,CEO 2 and AVDO 2 decreased.With mild to moderate elevations of ICP,SjO 2 increased,CEO 2 and AVDO 2 decreased;with severe elevation of ICP,SjO 2 decreased,CEO 2 and AVDO 2 increased.Conclusions:When the brain is severely injured,there is cerebral hypoxia or ischemia during the first 24 hours,and cerebral hyperemia in the following secondfourth days. Severe elevation of ICP results in cerebral hypoxia and ischemia,but mild to moderate elevations of ICP do not.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第5期267-269,共3页
Chinese Critical Care Medicine
基金
全军"九五"医学科研规划基金资助项目!(98M101)
关键词
脑损伤
脑氧代谢
颅内压
severe head injury
cerebral oxygen metabolism
intracranial pressure
