重度脑外伤后动态监测局部脑氧饱和度的临床意义

Application of Dynamic Monitoring of Regional Cerebral Oxygen Saturation for Severe Traumatic Brain Injury

目的探讨重度脑外伤(sTBI)后,动态监测局部脑氧饱和度(SctO2)的临床意义。方法2017年12月至2019年1月,sTBI后24 h内患者33例,采用近红外光谱技术每6小时监测SctO2、颅内压(ICP)和脑灌注压(CPP),共7 d,记录入院时格拉斯哥昏迷评分(GCS)和伤后6个月格拉斯哥预后评分(GOS)。结果SctO2于监测第3天最低,随后逐渐升高;SctO2与ICP呈负相关(r<-0.857,P<0.001),与GCS、CPP、GOS呈正相关(r>0.697,P<0.001)。结论sTBI后SctO2监测可早期识别部分继发性损伤,判断疾病严重程度,并部分预测疾病结局。

Objective To investigate the value of clinical monitoring of regional cerebral oxygen saturation(SctO2)for severe traumatic brain injury(sTBI).Methods From December,2017 to January,2019,33 patients with sTBI within 24 hours were monitored SctO2,intracranial pressure(ICP)and cerebral perfusion pressure(CPP)with near-infrared spectroscopyonce per six hours for seven days.They were assessed with Glasgow Coma Score(GCS)at admission and Glasgow Outcome Score(GOS)six months after injury.Results SctO2 was the lowest on the third day of monitoring,and then increased gradually.SctO2 negatevely correlated with ICP(r<-0.857,P<0.001),and positively correlated with GCS,CPP and GOS(r>0.697,P<0.05).Conclusion SctO2 monitoring is valuable after sTBI to identify the secondary injuries and severity of injuries,and predict the outcome partly.