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目的观察不同浓度、不同时间吸氧对重型颅脑损伤患者脑氧供需平衡的影响。方法60例重型颅脑损伤患者,按双盲随机的方法分成3组,每组各20例。对照组采用25%～29%浓度的鼻导管吸氧方式,观察1组采用29%～37%浓度的面罩吸氧方式,观察2组采用45%～53%浓度的面罩吸氧方式,每天吸氧5～8h后再改为29%～37%的面罩吸氧方式。检测入院后第24、48、72小时动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2),并进行比较。结果3组患者经不同浓度、不同时间吸氧治疗后动脉血气分析结果比较,总体差异均有统计学意义(P均<0.05)。PaO2、PaCO2、SaO2等指标在不同组间,观察2组可达正常值,明显优于对照组及观察1组;在不同吸氧时间,吸氧72h可达正常值,明显优于24h及48h。结论重型颅脑损伤可出现脑氧供需失衡,不同浓度、不同时间吸氧治疗对脑氧供需平衡有明显影响。
Objective To observe the effects of oxygen in different concentration and time on the balance of cerebral oxygen supply and demand in patients with severe craniocerebral injury. Methods Sixty patients with severe craniocerebral injury were divided into three groups according to a double-blind randomized method, with 20 cases in each group. In the control group, the nasal catheter oxygen concentration of 25% -29% was used. One group was treated with 29% -37% mask oxygen concentration, and the other two groups were treated by mask oxygen absorption of 45% -53% concentration. Oxygen 5 ~ 8h and then changed to 29% ~ 37% mask oxygen way. PaO2, PaCO 2 and SaO 2 were measured 24, 48 and 72 hours after admission, and compared. Results The results of arterial blood gas analysis after 3 groups of patients were treated with oxygen at different concentrations and time were statistically significant (P all <0.05). PaO2, PaCO2, SaO2 and other indicators in different groups, the observation group 2 up to normal, significantly better than the control group and observation group 1; at different oxygen exposure time, up to 72h after oxygen up to normal, significantly better than 24h and 48h . Conclusions There is an imbalance between supply and demand of cerebral oxygen in severe craniocerebral injury. Different concentrations and different times of oxygen treatment have obvious effect on the balance between supply and demand of cerebral oxygen.