CAJ | 학술논문

目的观察特重型颅脑损伤后脑组织氧代谢的改变,探讨伤后早期常压高浓度氧气的治疗作用.方法 2011年1月-2013年1月将68例特重型颅脑损伤患者按随机数字表法分为两组:对照组(34例)持续给予浓度50％的氧气吸入,治疗组(34例)给予浓度80％的氧疗,持续1周.比较患者第1,3,5,7天的动脉血氧分压(PaO2)、颈内静脉血氧分压(PjvO2)、动脉血氧含量(CaO2)、颈内静脉血氧含量(CjvO2)、脑动静脉血氧含量差(Da-jvO2)、脑氧摄取率(CERO2)、颈内静脉-动脉血乳酸差(Djv-a Lac)、GCS评分及血清特异性烯醇化酶(NSE)等指标.结果治疗组各时相点PaO2和第5,7天的GCS评分显著高于对照组(P＜0.05),第3,5,7天的Djv-aLac和第7天的NSE含量显著低于对照组(P＜0.05);各时相点PjvO2、CaO2、CjvO2、Da-jvO2、CERO2等指标两组间差异无统计学意义(P＞0.05).结论特重型颅脑损伤患者早期积极主动提高吸入氧浓度可能对氧吸入疗法预后具有重要意义.
목적 관찰특중형로뇌손상후뇌조직양대사적개변,탐토상후조기상압고농도양기적치료작용.방법 2011년1월-2013년1월장68례특중형로뇌손상환자안수궤수자표법분위량조:대조조(34례)지속급여농도50％적양기흡입,치료조(34례)급여농도80％적양료,지속1주.비교환자제1,3,5,7천적동맥혈양분압(PaO2)、경내정맥혈양분압(PjvO2)、동맥혈양함량(CaO2)、경내정맥혈양함량(CjvO2)、뇌동정맥혈양함량차(Da-jvO2)、뇌양섭취솔(CERO2)、경내정맥-동맥혈유산차(Djv-a Lac)、GCS평분급혈청특이성희순화매(NSE)등지표.결과 치료조각시상점PaO2화제5,7천적GCS평분현저고우대조조(P＜0.05),제3,5,7천적Djv-aLac화제7천적NSE함량현저저우대조조(P＜0.05);각시상점PjvO2、CaO2、CjvO2、Da-jvO2、CERO2등지표량조간차이무통계학의의(P＞0.05).결론 특중형로뇌손상환자조기적겁주동제고흡입양농도가능대양흡입요법예후구유중요의의.
Objective To observe the changes of brain oxygenation in patients with extremely severe craniocerebral injury and the therapeutic effect of early normobaric hyperoxia.Methods Sixtyeight patients with extremely severe craniocerebral injury treated from January 2011 to January 2013 were assigned to two groups according to the random number table:50％ oxygen breathing for one week in control group (34 cases) and 80％ oxygen breathing for one week in treatment group (34 cases).Blood samples from jugular vein and radial artery were collected at 1,3,5,and 7 days to measure indices of blood gas analysis,i.e.,PaO2,PjvO2,CaO2,CjvO2,Da-jvO2,CERO2 and Djv-a Lac.GCS and content of neuron-specific enolase (NSE) were recorded as well.Results Values of PaO2 at each time point and GCS at 5 and 7 days were significantly higher in treatment group than in control group (P ＜0.05).Djv-a Lac at 3,5 and 7 days and NSE at 7 days revealed significantly higher levels in treatment group than in control group(P ＜ 0.05).Whereas at each time point,there were no significant differences between the two groups in aspects of PjvO2,CaO2,CjvO2,Da-jvO2 and CERO2 (P ＞ 0.05).Conclusion Early use of 100％ oxygen in patients with extremely severe craniocerebral injury may be beneficial to the prognosis.