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目的评估颈内静脉氧饱和度(SjvO2)作为重型颅脑损伤的预后指标及与脑灌注压(CPP)的相关性。方法回顾性分析2006年10月至2008年5月上海市闵行区中心医院收治的32例重型颅脑损伤患者,每6h测定一次颈静脉搏氧饱和度,持续监测平均动脉压(MAP)及颅内压(ICP)。结果SjvO2与重型颅脑损伤预后显著相关,SjvO2≤50%或SjvO2≥75%发作2次以上提示预后不良。在CPP<70mmHg,SjvO2与CPP有显著的相关性,而CPP≥70mmHg组患者中,SjvO2与CPP无明显相关性。结论SjvO2与CPP监测相结合,能较可靠地反映脑供血及脑代谢状况,对重型颅脑损伤的治疗有指导意义。
Objective To evaluate the relationship between the SjvO2 of the jugular vein and the cerebral perfusion pressure (CPP) as a prognostic indicator of severe craniocerebral injury. Methods A retrospective analysis of 32 patients with severe traumatic brain injury admitted to Central Hospital of Minhang District in Shanghai from October 2006 to May 2008 was performed. The jugular venous oxygen saturation was measured every 6 hours and the mean arterial pressure (MAP) and cranial Internal pressure (ICP). Results SjvO2 was significantly associated with the prognosis of severe craniocerebral injury. SjvO2≤50% or SjvO2≥75% occurred more than 2 times, suggesting a poor prognosis. There was a significant correlation between SjvO2 and CPP at CPP <70mmHg, while there was no significant correlation between SjvO2 and CPP in patients with CPP≥70mmHg. Conclusion The combination of SjvO2 and CPP monitoring can more reliably reflect the status of cerebral blood supply and brain metabolism, which is instructive for the treatment of severe craniocerebral injury.