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目的探求手术治疗重型颅脑损伤患者脑组织氧分压(PbtO2)变化的临床意义。方法对42例急性重型脑损伤患者(均在全麻下急诊行血肿清除术和/或去骨瓣减压术),并且符合GCS≤8分,术前以及术后行PbtO2持续监测,同时行血电解质、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PcaO2)测定;分析PbtO2变化的临床意义。结果预后良好及预后不良组经过手术的干预,8、24、48、72h后PbtO2均明显升高,与术前相比差异有统计学意义(P<0.05);而在预后死亡组中,术后8、24、48hPbtO2与术前相比差异均无统计学意义(P>0.05)。没有发生与插入监测电极相关的并发症。结论脑组织氧分压测定是一种安全、灵敏、可靠的局部脑组织氧监测方法,可反映出重型脑损伤后的脑组织缺血缺氧情况,对临床治疗具有重要的指导作用。持续脑组织氧分压监测可判断重型脑外伤患者预后。
Objective To investigate the clinical significance of the changes of oxygen partial pressure (PbtO2) in brain tissue of patients with severe craniocerebral injury. Methods Forty-two patients with acute severe brain injury (all underwent emergency hematoma and / or decompressive craniectomy under general anesthesia) were enrolled in this study. The patients were followed up for PbtO2 monitoring before and after GCS≤8, Blood electrolytes, PaO2, and PcaO2 were measured. The clinical significance of PbtO2 changes was analyzed. Results The prognosis was poor and the prognosis was poor. After operation, the PbtO2 levels were significantly increased at 8, 24, 48, and 72 hours after operation (P <0.05). However, in the prognosis death group, After 8,24,48 hPbtO2 compared with the preoperative difference was not statistically significant (P> 0.05). There were no complications associated with inserting the monitor electrode. Conclusion The partial pressure of oxygen in brain tissue is a safe, sensitive and reliable method for local brain tissue oxygen monitoring. It can reflect the situation of cerebral ischemia and hypoxia after severe brain injury and play an important guiding role in clinical treatment. Continuous partial pressure of oxygen in brain tissue can determine the prognosis of patients with traumatic brain injury.