严重脑损伤患者颈静脉球血氧饱和度的变化及其意义

目的探讨监测严重脑损伤患者颈静脉球氧饱和度的意义.方法选择多种原因引起的脑损伤患者17例(其中严重脑损伤14例),通过呼吸循环支持生命体征平稳,动脉氧饱和度达1左右时,通过颈内静脉插管采血测定颈内静脉氧饱和度(SjO2),并分析其与格拉斯哥昏迷评分(GCS)及大脑皮质直接损伤间的关系.结果颈内静脉氧饱和度与GCS呈显著负相关(r=-0.801,P<0.001).有大脑皮质直接损伤组患者SjO2显著高于无大脑皮质直接损伤组.结论颈内静脉氧饱和度增加可能是脑细胞摄取氧能力下降及脑血流增加的综合反映,可以判断是否存在相对脑充血.

The changes and significance of jugular bulb oxyhemoglobin saturation in patients with severe head injury

Objective:To explore the significance of monitoring jugular bulb oxyhemoglobin saturation in patients with severe head injury.Methods:Seventeen patients with head injury caused by various causes (14 patients with severe head injury) were selected.After their vital signs were stabilized by circulation and ventilation support,and the saturation of arterial blood was maintained to near 100%,obtain blood sample through jugular catheter,jugular bulb oxyhemoglobin saturation were measured.Furthermore,the relationship of jugular bulb oxyhemoglobin saturation with Glasgow coma scale(GCS) and direct cerebral cortex injury was analyzed.Results:Jugular bulb oxyhemoglobin saturation was negatively correlated with GCS (r=-0.801,P<0.001).The jugular bulb oxyhemoglobin saturation of patients with direct cerebral cortex injury were significantly higher than that of patients with no direct cerebral cortex injury.Conclusions:The increase of jugular bulb oxyhemoglobin saturation might reflect the increase of cerebral blood flow,as well as the decrease of cerebral extraction of oxygen.It can be used to detect if a relative encephalemia state is existing.