期刊文献+

重型颅脑损伤后局部脑氧饱和度的监测及意义 被引量:5

Monitoring and clinical significance of regional cerebral oxygen saturation after severe brain trauma
下载PDF
导出
摘要 目的探讨重型颅脑损伤后局部脑氧饱和度(rScO2)的变化规律及意义。方法选择29例重型颅脑损伤病人为研究对象,采用近红外线光谱仪(NIRS)持续监测rScO2,与脉搏血氧饱和度(SpO2)、动脉血氧饱和度(SaO2)、平均动脉压(MAP)、颅内压(ICP)和脑灌注压(CPP)等,并将监测结果进行分析比较。结果重型颅脑损伤后rScO2均明显降低。23例存活病人术后早期rScO2呈不同程度上升,此后随ICP变化呈普遍下降然后又逐步上升的趋势。另6例rScO2呈持续性降低者均死亡。SpO2、SaO2、MAP除在死亡病例临死前进行性降低外,整个监测过程中均正常。结论NIRS持续监测rScO2能准确反映重型颅脑损伤后脑氧代谢的变化规律,对临床治疗及预后评估也有重要价值。 Objective To investigate the changes and significance of regional cerebral oxygen saturation (rScO2) after severe brain trauma. Methods Twenty-nine comatose patients admitted to our hospital after severe brain trauma were given continuously monitoring of regional cerebral oxygen saturation (rScO2) by near-infrared spectroscopy (NIRS). Arterial oxygen saturation (SaO2), pulse oxygen saturation (SpO2), mean arterial blood pressure (MAP), intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were monitored at the same time. Results rScO2 reduced dramatically in all patients after brain trauma. In 23 survivals, rScO2 went up shortly after operations, then declined for various duration,at last it restored gradually with the normalization of ICP.In 6 dead cases, rScO2 reduced continuously; however, SpO2?SaO2?MAP showed no significant change before patients died. Conclusions rScO2 can reflect cerebral oxygen metabolism accurately after severe brain trauma. rScO2 montoring is valuable in judging prognosis and guiding treatment.
作者 金科 兰青
出处 《中国微侵袭神经外科杂志》 CAS 2004年第6期248-251,共4页 Chinese Journal of Minimally Invasive Neurosurgery
关键词 重型颅脑损伤 局部脑氧饱和度 监测 预后 severe brain trauma regional cerebral oxygen saturation monitoring prognosisF犜J
  • 相关文献

参考文献12

  • 1俞森洋..现代机械通气的理论和实践[M],2000.
  • 2[3]Abdul-Khaliq H, Schubert S, Troitzsch D, et al. Dynamic changes in cerebral oxygenation related to deep hypothermia and circulatory arrest evaluated by near-infrared spectroscopy [J]. Acta Anaesthesiol Scand, 2001; 45(6): 696-701. 被引量:1
  • 3[4]McCormick PW, Stewart M, Goetting MG, et al. Regional cerebrovascular oxygen saturation measured by optical spectroscopy in humans [J]. Stroke, 1991; 22(5): 596-602. 被引量:1
  • 4毛青,侍行文,丁美修.100例健康成人脑氧饱和度测定[J].上海第二医科大学学报,1997,17(1):54-55. 被引量:6
  • 5杭燕南,刘仁玉,王祥瑞,孙大金.脑氧饱和度监测的临床意义及评价[J].中华麻醉学杂志,1995,15(6):244-246. 被引量:8
  • 6高晋健,唐文渊.重型脑损伤局部脑氧饱和度变化及影响因素[J].中华创伤杂志,1999,15(3):169-171. 被引量:17
  • 7[8]Dullenkopf A, Frey B, Baenziger O, et al. Measurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter[J]. Paediatr Anaesth, 2003; 13(5): 384-391. 被引量:1
  • 8[9]Kett-White R, Hutchinson P J, Czosnyka M, et al. Multi-modal monitoring of acute brain injury [J]. Adv Tech Stand Neurosurg, 2002; 27: 87-134. 被引量:1
  • 9[10]Schaller B. Craniocerebral trauma-new pathophysiological and therapeutic viewpoints. 1: Management of the acute phase [J]. Swiss Surg, 2002; 8(3): 123-137. 被引量:1
  • 10[11]Sahuquillo J, Poca MA, Arribas M, et al. Interhemispheric supratentorial intracranial pressure gradients in head-injured patients: are they clinically important [J]? J Neurosurg, 1999;90(1): 16-26. 被引量:1

二级参考文献1

  • 1Chan K H,Neurosurgery,1992年,77卷,55页 被引量:1

共引文献27

同被引文献49

  • 1张延铭,阎学江,赵卫生.颅脑创伤病人的脑氧代谢监测[J].中国微创外科杂志,2005,5(3):252-254. 被引量:3
  • 2管义祥,陆正,缪永华,曹桂龙,吴德模.重型颅脑损伤患者持续脑组织氧分压监测的临床意义[J].中华创伤杂志,2006,22(3):225-226. 被引量:10
  • 3徐跃峤.镇静药物在神经外科重症监护病房中的应用[J].北京医学,2006,28(9):562-564. 被引量:7
  • 4Glay H D.Validity and reliability of SjVo2 catheter in neurologically impaired patients:a critical review of the literature[J].J Neurosci Nurs,2003,32(4):194. 被引量:1
  • 5Gopinath S P,Valadka A B,Masahiko,et al.Comparison of jugular venous oxygen saturation and brain tissue PO2 as monitors of cerebral ischmia after head injury[J].Critical Care Medcine,1999,27(11),2337. 被引量:1
  • 6Valadka A B,Gopinath S P,Contant C F,et al.Relationship of brain tissue PO2 to outcome after severe head injury[J].Critical Care Medicine,1998,26(9):1576. 被引量:1
  • 7Shankar P,Alex B,Masahiko,et al.Comparison of jugular venous oxygen saturation and brain tissue PO2 as monitors of cerebral ischmia after head injury[J].Critical Care Medcine,1999,27(11):2337. 被引量:1
  • 8Doppenberg E M,Zauner A,Billock R,et al.Correlations between brain tissue oxygen tension,carbon dioxide tension,pH and cerebral blood flow-a better way of monitoring the severely injured brain[J].Surg Neurol,1998,49:650. 被引量:1
  • 9Roman H,Alex B,Shankar P,et al.Brain tissue oxygen tension response to induced hyperoxia reduced in hypoperfused brain[J].J Neurosurg,2008,108:53. 被引量:1
  • 10Mass A,Fleckenstein W,Jong A,et al.Monitoring cerebral oxygenation:experimental syudies and preliminary clinical results of continuous monitoring of cerebral fluid and brain tissue oxygen tension[J].Acta Neurochir,1993,59:50. 被引量:1

引证文献5

二级引证文献17

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部