氧代谢监测在严重创伤治疗中的应用

The Use of Monitoring Oxygen Metabolism in the Treatment of Severe Trauma

目的：探讨严重创伤患者氧供求平衡的机制和临床指导意义，估价氧疗的治疗作用．方法：对６１例严重创伤患者混合静脉血氧饱和度（ＳｖＯ２）进行动态监测，并与ＡＰＡＣＨＥⅡ伤情严重度评分作相关性分析．结果：（１）治疗后ＳｖＯ２明显上升组治愈率显著高于ＳｖＯ２下降组．（２）伤情严重度、ＳｖＯ２和治愈率之间有显著相关性．结论：ＳｖＯ２在严重创伤氧代谢监测中有重要意义，并且是组织氧利用的良好标志．它既能反映呼吸功能，也能反映循环功能．提高ＳｖＯ２要在提高心排出量（ＣＯ）和动脉血氧饱和度（ＳａＯ２），以及降低氧消耗（ＶＯ２）上下功夫．

Aim: To evaluate the effects of oxygen therapy in the treatment of severe trauma by monitoring mixed venous oxygen saturation (SO 2). Methods: We studied the correlation between SO 2 and APAHEⅡ score in 61 patients with severe trauma to understand the mechanism of the balance between supply and consumption of oxygen in severe trauma and its clinical implication. In this study, oxygen saturation of central venous blood (SO 2) in 57 cases was measured in place of SO 2. Results: After systemic treatment, the cure rate in the group with obviously increaed SO 2 was significantly higher than that in the group with obviously decreased SO 2. There was significant correlation between injury severity, SO 2 and cure rate. Conclusion:SO 2 was of great importance in the monitoring of oxygen metabolism in severe trauma, and was a good index of tissue oxygen utilization. It could reflect both respiration function and circulation function. To increase SO 2, great efforts should be made to improve cardiac output (CO) and oxygen saturation of arterial blood (SaO 2), and to lower oxygen consumption (O 2). Thus, cure rate can be increased.