颈内静脉氧饱和度与脑灌注压在重型颅脑损伤中的意义 |
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引用本文: | 徐福林,王建清,徐征,马捷,全勇,贾丕丰,盖延廷,茅宇航,沈刚. 颈内静脉氧饱和度与脑灌注压在重型颅脑损伤中的意义[J]. 中华危重症医学杂志(电子版), 2008, 1(2) |
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作者姓名: | 徐福林 王建清 徐征 马捷 全勇 贾丕丰 盖延廷 茅宇航 沈刚 |
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作者单位: | 上海市闵行区中心医院神经外科,上海,201100 |
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摘 要: | 目的 评估颈内静脉氧饱和度(SjvO2)作为重型颅脑损伤的预后指标及与脑灌注压(CPP)的相关性. 方法 回顾性分析2006年10月至2008年5月上海市闵行区中心医院收治的32例重型颅脑损伤患者,每6 h测定一次颈静脉搏氧饱和度,持续监测平均动脉压(MAP)及颅内压(ICP). 结果 SjvO2与重型颅脑损伤预后显著相关,SjvO2≤50%或SjvO2≥75%发作2次以上提示预后不良.在CPP<70 mm Hg,SjvO2与CPP有显著的相关性,而CPP≥70 mm Hg组患者中,SjvO2与CPP无明显相关性. 结论 SjvO2与CPP监测相结合,能较可靠地反映脑供血及脑代谢状况,对重型颅脑损伤的治疗有指导意义.
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关 键 词: | 重型颅脑损伤 颈内静脉氧饱和度 脑灌注压 预后 |
Significance of jugular vein oxygen saturation and cerebral perfusion pressure in severe head injury |
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Abstract: | Objective To estimate the effects of jugular blood oxygen saturation (SjvO2) on prognosis of severe head injury and its relationship with cerebral perfusion pressure(CPP). Methods Thirty-two patients with severe head injury, in Minghang Central Hospital, Shanghai, between October 2006 and May 2008, were retrospectively analyzed. SjvO2 was detected every 6 hours. Continuous measurements of mean arterial pressure(MAP) and ICP were performed to assess the dependence of SjvO2 on the CPP. Results SjvO2 was significantly correlated with prognosis, SjvO2≤50% or ≥75% episodes two or more was associated with a poor neurology outcome. Changes of CPP induced highly significant alterations in SjvO2 in the patients with CPP<70mm Hg. On the contrary, in the patients with CPP≥70 mm Hg, there was no correlation. Conclusions SjvO2 and CPP are reliable to predict prognosis of severe head injuries and helpful to treatment. |
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Keywords: | Severe brain injury Jugular vein blood oxygen saturation Cerebral perfusion pressure Prognosis |
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