血与脑脊液气体及酸碱含量检测的比较及临床意义

Changes and clinical value of gas acid-base levels in blood and CSF after brain injury

目的 通过对血与脑脊液 (CSF)气体及酸碱含量检测的比较 ,探讨其临床价值。方法 应用美国CI BACORNING - 2 48型全自动血气分析仪 ,对 6 0例中型和重型颅脑损伤的病人于伤后 2 4小时内检测比较动脉血和CSF的PH、PCO2 、PO2 及HCO3 -含量 ,选非创伤病人为对照组。结果 外伤组血和CSF的PO2 含量值均低于对照组 ,重型组下降更为明显 ,动脉血PO2 平均值比对照组下降 0 .85kPa(P <0 .0 1 ) ,CSF的PO2 下降 2 .78kPa(P <0 .0 1 ) ;重型组的血PCO2 平均值比对照组下降 0 .72kPa(P <0 .0 1 ) ,CSF的PCO2 平均值升高 0 .6 5kPa(P <0 .0 1 ) ,提示血和CSF之间酸碱变化程度和性质不相一致 ,CSF较血液变化更明显。结论 脑损伤病人早期血和CSF均处于低氧与不同程度和类型的酸碱失调状态 ,检测比较血和CSF酸碱变化 ,可及时明确体内酸碱失调类型 。

Objectives To explore the changes and clinical value of gas,acid-base levels in artery blood and CSF after brain injury.Methods Both in artery blood and CSF,pH,PCO 2,PO 2 HCO 3 - levels were measured in 60 patients after brain injury.Results In artery blood and CSF, PO 2 levels were significantly lower in patients than that in controls.The changes in CSF are more obviously than that in artery blood.Conclusions Hypoxia and kinds of acid-base clisturbance are existed at the early stage of the craniocerebral injuried patients,checking out the changes of the acid-base levels in artery blood and CSF may appear to be of importance for patients with brain injury.