摘要
目的探讨特重度颅脑损伤患者早期脑氧代谢变化及其对患者预后的影响。方法自2009年6月至2011年7月ICU治疗的27例特重度颅脑损伤患者,采集其颈静脉与桡动脉血进行血气分析及血葡萄糖测定,计算脑氧利用率(O2Ucc),以及颈内静脉与动脉血二氧化碳分压差(V-APCO2)、血乳酸差(V-ALac)、血糖差(V-AGlu)的绝对值和颈内静脉血氧饱和度(SjvO2),根据近期预后将患者分为存活组和死亡组,对两组患者上述观察指标进行比较。结果与死亡组比较,存活组V-ALac显著降低(P<0.01),O2Ucc、V-APCO2、SjvO2明显升高(P<0.01),而V-AGlu变化不明显(P>0.05)。结论特重度颅脑损伤患者早期存在脑氧代谢异常,O2Ucc、V-ALac、V-APCO2、SjvO2等指标可作为评估患者预后的指标。
Objective To study the changes of brain oxygen metabolism in patients with acute severe craniocerebral injury, and the in- fluence on the prognosis of the patients. Methods A total of 27 patients with acute severe eranioeerebral injury were selected from June 2009 to July 2011 in ICU, their blood from jugular vein and radial artery was collected, the blood gas analysis were performed and blood sugar were assayed. The cerebral oxygen utilization coefficients （O2Ucc）, and difference of CO2 partial pressure （V-APCO2）, lactic acid （V-ALac） and blood sugar （V-AGIu） between jugular vein and radial artery were calculated and O2 suturation of jugular venous blood （SjvO2） were de- termined. All patients were divided into the survival group and the death group according to the early prognosis, and the index was compared be- tween two groups. Results Compared with the death group, the V-ALac was lower in the survival group significantly （P〈0.01）, O2Ucc, V- APCO2 and SjvO2 were increased in the survival group obviously （P〈0.01）. V-AGlu had not significant difference between two groups （P〉 0.05）. Conclusion The changes of cerebral oxygen metabolism exist in patients with acute severe craniocerebral injury. O2Uce, V-ALc, V- APCO2, SjvO2 can be used as indices of the prognosis evaluation.
出处
《安徽医学》
2012年第6期666-668,共3页
Anhui Medical Journal
基金
安徽医科大学校科研基金项目(2011XKJ046)
关键词
特重度颅脑损伤
氧代谢
预后
Severe eraniocerebral injury
Oxygen metabolism
Prognosis
