近红外光谱无创监测局部脑氧饱和度在重型颅脑损伤术后治疗中的应用研究

Application of NIR noninvasive monitoring of local cerebral oxygen saturation in postoperative treatment of severe craniocerebral injury

目的分析重型颅脑损伤术后治疗中采用近红外光谱无创监测局部脑氧饱和度(rScO2)的临床效果。方法于河南省人民医院2017年1月-2019年1月期间收治的重型颅脑损伤患者中选取30例,所有患者均给予急诊开颅手术治疗,并使用近红外光谱对患者的局部rScO2进行无创监测,分析患者的rScO2变化特征及与颅内压(ICP)的关系。结果 rScO2与ICP呈负相关(r=-0.796,P<0.05),rScO2与CPP呈正相关(r=0.875,P<0.05)。rScO2值与重型颅脑损伤患者的预后程度有关,患者预后越好其rScO2值越高,术后早期预后良好、中度残疾和重度残疾患者均会出现rScO2值下降的情况,之后在颅内高压缓解后rScO2值可再次呈上升趋势。结论近红外光谱能够较为准确地监测重型颅脑损伤术后患者的局部rScO2,能够为患者临床治疗及预后评估提供重要依据。

Objective to analyze the clinical effect of non-invasive monitoring of local cerebral oxygen saturation(rScO2) by near-infrared(NIR) spectroscopy in the postoperative treatment of severe craniocerebral injury. Methods 30 cases of patients with severe craniocerebral injury admitted to our hospital from January 2017 to January 2019 were selected. All patients were treated with emergency craniotomy, and the local rScO2 of patients was monitored noninvasitively by near-infrared spectroscopy to analyze the change characteristics of patients’ rScO2 and its relationship with intracranial pressure(ICP).Results rScO2 was negatively correlated with ICP(r=-0.796, P<0.05), and positively correlated with CPP(r=0.875, P>0.05). rScO2 value is related to the prognosis of patients with severe craniocerebral injury. The better the prognosis, the higher the rScO2 value will be. Patients with moderate and severe disabilities will have a good prognosis in the early postoperative period, and rScO2 value will decline. Conclusion near-infrared spectroscopy can accurately monitor the local rScO2 of patients after severe craniocerebral injury, and can provide an important basis for clinical treatment and prognosis evaluation of patients.