颈内静脉氧饱和度与脑灌注压在重型颅脑损伤中的意义

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.

Significance of jugular vein oxygen saturation and cerebral perfusion pressure in severe head injury

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.