CAJ | 학술논문

目的：评估动静脉乳酸差值（ AVDL）和动静脉氧差（ AVDO2）在诊断重型颅脑损伤（ severe traumatic brain injury ，sTBI）病人中合并脑梗死的灵敏度、特异度、阳性似然比和阴性似然比。方法45例重型颅脑损伤病人，每6h抽取股动脉和颈静脉球血样本，计算AVDL和AVDO2，分析这两项指标的临床诊断价值。结果采集358例血样本，通过计算得出AVDL和AVDO2的值，AVDL的灵敏度为91％，特异度为84％，阳性似然比为5.69，阴性似然比为0.095； AVDO2的灵敏度为81％，特异度为89％，阳性似然比为7.36，阴性似然比为0.212，平行试验的联合灵敏度为94％。结论 AVDL和AVDO2对于合并创伤性脑梗死的诊断价值较高，床边联合监测有助于早期发现重型颅脑损伤合并脑梗死的存在。
목적：평고동정맥유산차치（ AVDL）화동정맥양차（ AVDO2）재진단중형로뇌손상（ severe traumatic brain injury ，sTBI）병인중합병뇌경사적령민도、특이도、양성사연비화음성사연비。방법45례중형로뇌손상병인，매6h추취고동맥화경정맥구혈양본，계산AVDL화AVDO2，분석저량항지표적림상진단개치。결과채집358례혈양본，통과계산득출AVDL화AVDO2적치，AVDL적령민도위91％，특이도위84％，양성사연비위5.69，음성사연비위0.095； AVDO2적령민도위81％，특이도위89％，양성사연비위7.36，음성사연비위0.212，평행시험적연합령민도위94％。결론 AVDL화AVDO2대우합병창상성뇌경사적진단개치교고，상변연합감측유조우조기발현중형로뇌손상합병뇌경사적존재。
Objective The study aims to determine the sensitivity , specificity,positive likelihood rate and negative likelihood rate of arteriojugular venous difference of lactate ( AVDL) and arteriojugular venous difference of oxygen ( AVDO2 ) as an indicator of associated brain infarction in patients with severe traumatic brain injury ( sT-BI).Methods Forty-five patients with acute and severe brain injuries were involved in this study .Blood samples were obtained through jugular bulb and femoral artery every six hours during the period of three days after injury . AVDL and AVDO2 were calculated for each patient .Results Totally 358 AVDL and AVDO2 determinations were collected.AVDL had a sensitivity of 91%, specificity of 84%,positive likelihood rate of 5.69 and negative likeli-hood rate of 0.095;AVDO2 had a sensitivity of 81%, specificity of 89%,positive likelihood rate of 7.36,and nega-tive likelihood rate of 0.212;the sensitivity was 94%with parallel tests .Conclusion Monitoring AVDL and AV-DO2 may be reliable to predict associated infarction damage in patients with sTBI .