中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
6期
631-634
,共4页
叶纪录%揭红英%濮雪华%朱志云
葉紀錄%揭紅英%濮雪華%硃誌雲
협기록%게홍영%복설화%주지운
颅脑损伤%脑氧代谢%血气分析%相关分析
顱腦損傷%腦氧代謝%血氣分析%相關分析
로뇌손상%뇌양대사%혈기분석%상관분석
Severe head injury%Cerebral oxygen metabolism%Blood gas analysis%Relation analysis
目的 观察颈内动-静脉血气分析、算出脑氧摄取率,并探讨颈内静脉血氧饱和度及脑氧摄取率与颅脑损伤预后的关系.方法 泰州市人民医院ICU收治的重型颅脑损伤患者70例,在经过紧急处理如保持呼吸道通畅、保证供氧、维持循环稳定,以及及时的开颅手术治疗后24 h抽取颈内动-静脉血进行血气分析.选轻度颅脑损伤患者80例作为对照组.观察分析指标有颈内动脉血氧饱和度(SaO2)、氧分压(PaO2),颈内静脉血氧饱和度(SjvO2)、氧分压(PjvO2),颈内动脉二氧化碳分压(PaCO2)、颈内静脉二氧化碳分压(PjvCO2)、颈内动-静脉血氧饱和度差(Sa-jvO2)=SaO2-SjvO2、颈内动-静脉氧分压差(Pa-jvO2)、颈内动-静脉二氧化碳分压差(Pa-jvCO2)、颈内动脉血氧含量(CaO2)、颈内静脉血氧含量(CjvO2)、颈内动-静脉血氧含量差(Ca-jvO2)=CaO2-CjvO2,脑氧摄取率(%)CEO2=Ca-ivO2/CaO2.结果 重度颅脑损伤患者较轻度颅脑损伤患者颈内静脉血气分析中SivO2,PjvO2差异具有统计学意义(P<0.05),另外Sa-jvO2,Pa-jvO2,Ca-jvO2,CEO2差异具有统计学意义(P<0.05).结论 SjvO2与CEO2联合分析能科学地表示脑组织摄氧量或耗氧量,能较好地反映颅脑损伤的预后.
目的 觀察頸內動-靜脈血氣分析、算齣腦氧攝取率,併探討頸內靜脈血氧飽和度及腦氧攝取率與顱腦損傷預後的關繫.方法 泰州市人民醫院ICU收治的重型顱腦損傷患者70例,在經過緊急處理如保持呼吸道通暢、保證供氧、維持循環穩定,以及及時的開顱手術治療後24 h抽取頸內動-靜脈血進行血氣分析.選輕度顱腦損傷患者80例作為對照組.觀察分析指標有頸內動脈血氧飽和度(SaO2)、氧分壓(PaO2),頸內靜脈血氧飽和度(SjvO2)、氧分壓(PjvO2),頸內動脈二氧化碳分壓(PaCO2)、頸內靜脈二氧化碳分壓(PjvCO2)、頸內動-靜脈血氧飽和度差(Sa-jvO2)=SaO2-SjvO2、頸內動-靜脈氧分壓差(Pa-jvO2)、頸內動-靜脈二氧化碳分壓差(Pa-jvCO2)、頸內動脈血氧含量(CaO2)、頸內靜脈血氧含量(CjvO2)、頸內動-靜脈血氧含量差(Ca-jvO2)=CaO2-CjvO2,腦氧攝取率(%)CEO2=Ca-ivO2/CaO2.結果 重度顱腦損傷患者較輕度顱腦損傷患者頸內靜脈血氣分析中SivO2,PjvO2差異具有統計學意義(P<0.05),另外Sa-jvO2,Pa-jvO2,Ca-jvO2,CEO2差異具有統計學意義(P<0.05).結論 SjvO2與CEO2聯閤分析能科學地錶示腦組織攝氧量或耗氧量,能較好地反映顱腦損傷的預後.
목적 관찰경내동-정맥혈기분석、산출뇌양섭취솔,병탐토경내정맥혈양포화도급뇌양섭취솔여로뇌손상예후적관계.방법 태주시인민의원ICU수치적중형로뇌손상환자70례,재경과긴급처리여보지호흡도통창、보증공양、유지순배은정,이급급시적개로수술치료후24 h추취경내동-정맥혈진행혈기분석.선경도로뇌손상환자80례작위대조조.관찰분석지표유경내동맥혈양포화도(SaO2)、양분압(PaO2),경내정맥혈양포화도(SjvO2)、양분압(PjvO2),경내동맥이양화탄분압(PaCO2)、경내정맥이양화탄분압(PjvCO2)、경내동-정맥혈양포화도차(Sa-jvO2)=SaO2-SjvO2、경내동-정맥양분압차(Pa-jvO2)、경내동-정맥이양화탄분압차(Pa-jvCO2)、경내동맥혈양함량(CaO2)、경내정맥혈양함량(CjvO2)、경내동-정맥혈양함량차(Ca-jvO2)=CaO2-CjvO2,뇌양섭취솔(%)CEO2=Ca-ivO2/CaO2.결과 중도로뇌손상환자교경도로뇌손상환자경내정맥혈기분석중SivO2,PjvO2차이구유통계학의의(P<0.05),령외Sa-jvO2,Pa-jvO2,Ca-jvO2,CEO2차이구유통계학의의(P<0.05).결론 SjvO2여CEO2연합분석능과학지표시뇌조직섭양량혹모양량,능교호지반영로뇌손상적예후.
Objective To observe blood gas analysis of internal carotid artery and internal jugular vein to calculate the cerebral extraction of oxygen, and to investigate the relationship between oxyhemoglobin in internal jugular vein, cerebral extraction of oxygen, and the prognosis of patients with head injury. Method Seventy patients with acute severe head injury in ICU of Taizhou People Hospital were studied, and another 80 patients with mild head injury were enrolled as controls. Twenty-four hours after first aid such as keeping airway open and circulatory and ventilation support, and emergency craniotomy, the blood samples from internal carotid artery and internal jugular vein were collected for blood gas analysis including SaO2, PaO2, SjvO2, PJVO2 > PaCO2, PJVCO2, SaO2-SjvO2, Pa-jvCCO2, CaO2-CjvO2 and Ca-jvO2/CaCO2 (CEO2, cerebral oxygen extraction). Results There were significant differences in SjvO2, PjvO2, Sa-jvO2, Pa-jvO2 Ca-jvO2 and CEO2 between two groups. Conclusions The SjvO2 and CEO2 represent the cerebral oxygen uptake and oxygen consumption precisely, and they can be used to predict the outcome of patients with severe craniocerebral trauma commendabiy.