摘要
目的评估动静脉乳酸差值(AVDL)和乳酸氧合指数(LOI)在诊断重型颅脑损伤合并脑梗死患者的灵敏度、特异度,探索重症监护病房预测继发性脑梗死的一种床边监测工具,以期及早发现病情,及时干预。方法前瞻性分析29例重型颅脑损伤,每6h抽取股动脉和颈静脉球部血样本,计算AVDL、动静脉氧含量差值(AVDO2)及LOI,入院后第1、3、5、7天行头颅CT扫描作为诊断脑梗死的金标准。结果采集298例血样本,通过计算得出AVDL的灵敏度为92%,特异度为88%;LOI的灵敏度为92%,特异度为77%,平行试验的联合灵敏度为96%。结论联合床边监测AVDL、LOI有助于早期发现重型颅脑损伤合并脑梗死的存在,及早预防和干预,有利于改善预后。
Objective To determine the sensitivity, specificity of arteriovenous lactate differences （ AVLD ） and lactate-oxygen index （ LOI ） as indicators of brain ischemia in patients with traumatic brain injury （ TBI ）. Methods Clinical data of 29 severe head injury patients were prospectively analyzed . AVLD, cerebral arteriovenous oxygen difference （ AVDO2 ） , LOI were calculated every 6 hours using samples obtained through a catheter placed in the jugular bulb in patients with severe head injury. Head CT scanning was performed 1,3,5,7 days for di- agnosing cerebral in farction. Results Totally 298 blood samples were obtained. AVLD had a sensitivity of 92% and specificity of 88% ;LOI had a sensitivity of 92% and specificity of 77%. The sensitivity was 96% with parallel tests. Conclusion Monitoring AVLD and LOI may be reliable to predict secondary ischemie damage in patients with TBIs,and is also helpful to improve patients＇ prognosis.
出处
《创伤外科杂志》
2012年第6期502-504,共3页
Journal of Traumatic Surgery
关键词
颅脑损伤
脑梗死
乳酸
氧合指数
brain injury
cerebral infarction
lactate
oxygen index
