CAJ | 학술논문

目的研究戊巴比妥在外伤后顽固性颅内高压患者中应用,监测其对脑组织氧分压(PbtO2)的影响.方法顽固性颅内高压患者60例,分为对照组和治疗组,对照组采用常规治疗,治疗组除常规治疗外,于24 h内加用戊巴比妥.两组均持续监测PbtO2和颅内压(ICP),并对不同时段的PbtO2及ICP进行统计分析.于伤后3个月对患者行GOS评分并对两组患者预后进行比较.结果应用巴比妥治疗后24、48 h和72 h治疗组PbtO2[72 h:(26.7±6.7)mmHg]均高于对照组[72h:(21.1±7.2)mmHg](P<0.05),而给药第3天、第5天治疗组ICP[5 d:(2.48±1.11)kPa]均低于对照组[5 d:(3.12±1.09)kPa];治疗组预后优于对照组(P<0.05).结论戊巴比妥可以有效降低顽固性颅内高压患者的颅内压、提高脑组织氧分压、改善预后.PbtO2监测是一种较为理想的病情监测手段,并可以在一定程度上判断预后.
목적 연구무파비타재외상후완고성로내고압환자중응용,감측기대뇌조직양분압(PbtO2)적영향.방법 완고성로내고압환자60례,분위대조조화치료조,대조조채용상규치료,치료조제상규치료외,우24 h내가용무파비타.량조균지속감측PbtO2화로내압(ICP),병대불동시단적PbtO2급ICP진행통계분석.우상후3개월대환자행GOS평분병대량조환자예후진행비교.결과 응용파비타치료후24、48 h화72 h치료조PbtO2[72 h:(26.7±6.7)mmHg]균고우대조조[72h:(21.1±7.2)mmHg](P<0.05),이급약제3천、제5천치료조ICP[5 d:(2.48±1.11)kPa]균저우대조조[5 d:(3.12±1.09)kPa];치료조예후우우대조조(P<0.05).결론 무파비타가이유효강저완고성로내고압환자적로내압、제고뇌조직양분압、개선예후.PbtO2감측시일충교위이상적병정감측수단,병가이재일정정도상판단예후.
Objective To examine the barbiturate infusion for intractable intracranial hypertension and its effect on brain tissue oxygen ( PbtO2 ). Method 60 patients with intractable intracranial hypertension were divided into tow groups, experimental group and control group. PbtO2 and intracranial pressure (ICP) were continuous monitored. Follow-up was more than 3 months and the prognosis was compared between two groups. Results When pentobarbital administration began, the mean PbtO2 [ 72 h: (26. 7 ±6. 7)mmHg] at 24h, 48h and 72h in experimental group were significantly higher than that of control group [ 72 h: ( 21. 1 ± 7. 2) mmHg ] ( P < 0. 05 ). The mean ICP [ 5 d: (2. 48 ± 1.11 ) kPa ] in the third and fifth day of experimental group were lower than that of control group [ 5 d: (3. 12 ± 1.09 ) kPa ]. Prognosis of pentobarbital group was better than control group( P < 0. 05 ). Conclusions Pentobarbital can effectively reduce intracranial pressure in patients with refractory intracranial hypertension and improve brain tissue oxygen. PbtO2 is an ideal monitoring marker, and it can predict prognosis to a certain extent.