脓毒症患者脑氧供需平衡变化的临床研究

目的 探讨脓毒症患者颈静脉血氧饱和度（SjO2）、动脉-颈内静脉血氧含量差（AVDO2）、脑氧摄取（CEO2）变化与预后的关系。方法 观察60例脓毒症患者6～12h、24h、48h、72h、7d各时间点SjO2、AVDO3．CEO2的变化。结果 脓毒症患者入院6—12h时SjO2、AVDO2、CEO2明显高于对照组（P〈0．05），入院24h后脓毒症患者SjO2逐渐恢复止常，但脓毒性休克组AVDO2、CEO2明显低于脓毒症组（P〈0．01），当CEO2低于25％时，患者预后差。结论 脑氧供需平衡变化反映了脓毒症患者大脑神经细胞的功能和利用氧的能力，因此，可将脑氧供需平衡变化作为判断脓毒症预后的重要指标。

Changes of cerebral oxygen balance in patients with sepsis

Objective To investigate the relationship between the prognosis and the changes of jugular bulb oxygen saturation(SjO_2),arteriovenous oxygen content difference(AVDO_2) and cerebral extraction of oxygen(CEO_2) in the patients with sepsis.Methods The changes of SjO_2,AVDO_2 and CEO_2 in 60 patients with sepsis at admission and 6~12h,24,48h,72h,7d after admission were observed.Results At admission,SjO_2,AVDO_2 and CEO_2 in sepsis group were significantly higher than those in control group(P<0.05).SjO_2 gradually returned to normal,but AVDO_2,and CEO_2 in sepsis group were significantly lower than those in control group 24h after admission(P<0.01).When CEO_2 in sepsis group decreased to or less than 25%,the prognosis of the patients with sepsis was bad.Conclusion The changes of cerebral oxygen balance reflects the brain cells' functional state and their ability of extracting oxygen,so it can be served as an important prognostic marked index for evaluating sepsis.