重型脑损伤局部脑氧饱和度变化及影响因素

Changes of Regional Cerebral Oxygen Saturation After Severe Brain Injury and Influencing Factors

目的探讨重型脑损伤后局部脑氧饱和度（ｒＳｃＯ２）变化以及影响因素。方法重型脑损伤５０例为样本，采用近红外光谱血氧仪（ＮＩＲＳ）持续床旁监测ｒＳｃＯ２，颈静脉氧饱和度（ＳｊＯ２）、动脉氧饱和度（ＳａＯ２）、颅内压（ＩＣＰ）、脉搏氧饱和度（ＳｐＯ２）、平均动脉压（ＭＡＢＰ）和脑灌注压（ＣＰＰ）。结果重型脑损伤后ｒＳｃＯ２明显降低（０．４０７５±０．１３９４）。影响局部脑氧饱和度的主要因素为ＩＣＰ、ＣＰＰ、伤后病理及病情转归。结论本研究结果表明，ＮＩＲＳ持续、无创监测ｒＳｃＯ２有重要意义，它能反映重型脑伤后脑氧代谢的信息。局部脑氧饱和度显著降低提示预后不良。

Objective To investigate the changes in regional cerebral oxygen saturation and influencing factors after severe traumatic brain injury. Methods Fifty coma patients admitted to the hospital after severe head injury. They were continuously given noninvasive monitoring of regional cerebral oxygen saturation (rScO2), jugular venous oxygen saturation, arterial oxygen saturation, intracranial pressure, pulse oxygen saturation, mean arterial blood pressure, and cerebral perfusion pressure. Results The rScO2 was reduced after severe head injury (0407 50139 4). Traumatic degree, intracranial pressure, and cerebral perfusion pressure would affect rScO2 Conclusions It is important to monitor rScO2 because it can reflect cerebral oxygen metabolism. Significant reduction of rScO2 may indicate poor prognosis.