局部脑氧饱和度在监测脑血流自动调节中的应用

Application of regional cerebral oxygen saturation monitoring in cerebral autoregulation

脑血流自动调节(cerebral autoregulation, CA)是维持脑血流量相对稳定从而维持脑氧供需平衡的重要机制, 明确患者CA能力有助于评估患者预后;维持患者MAP在CA范围内有助于维持重要器官的灌注。但目前还没有理想的监测方式用于患者CA监测, 无创局部脑氧饱和度(regional cerebral oxygen saturation, rSO_(2))变化近似于脑血流量变化, 在临床中有无创、实时、持续监测的优势。文章从rSO2监测CA的原理、临床应用(包括围手术期、ICU中、小儿监测中)及其不足的研究进展进行阐述, 旨在探讨rSO2监测CA的研究及其临床应用中面临的主要问题和未来发展方向。

Cerebral autoregulation(CA)is an important mechanism to maintain the relative stability of cerebral blood flow and keep the balance of cerebral oxygen supply and demand.However,different individuals in different states have distinct CA capacity and regulation ranges.Identifying patients'CA capacity is helpful for evaluating patients'prognosis;maintaining patients'mean arteri‑al pressure(MAP)in CA range,helps maintain the perfusion of vital organs.However,currently,there is no ideal monitoring method for CA monitoring in patients.The change of non‑invasive regional cerebral oxygen saturation(rSO 2)is similar to the change of cerebral blood flow,which is beneficial to non‑invasive real‑time continuous monitoring blood flow in clinical practice.This review intends to de‑scribe the research advances on the principle,clinical application[including perioperative period,intensive care unit(ICU),and chil‑dren],and deficiencies of rSO 2 in CA monitoring and aims to discuss the main problems existing in the research and clinical application of rSO 2 for CA monitoring and future development directions.