海拔2260m重型颅脑损伤脑脊液酸碱气体分析与预后的临床观察──附21例分析  

CLINICAL OBSERVATION OF GAS ANALYSIS IN THE CEREBROSPINAL FLUID AND PROGNOSIS OF SEVERE CRANIOCEREBRAL INJURY AT 2 260m AREA-21 CASES ANALYSIS

作　　者：李文纲[1] 

机构地区：[1]青海省人民医院神经外科

出　　处：《高原医学杂志》1997年第2期37-39,共3页Journal of High Altitude Medicine

摘　　要：目的：重型颅脑损伤颅内压增高，中枢性呼吸功能障碍，脑组织缺血缺氧，通过对脑脊液酸碱气体分析，观察其分析结果与患者预后的关系。方法；患者在伤后24小时内和经治疗3天后，＃穿采集脑脊液进行pH值、PcsfO2、PCSfCO2、HCO3、SCSfO2的测定。结果：测定重型颅脑损伤后24，小时内pH值、PCSfO2、HCO3、Scsfo2降低和PcsfCO2高于正常值，表明脑组织缺氧和代谢性酸中毒，治疗3天后复查pH值、PcsfO2、HCO3和Scs－fO2上移，PcofCO2下降，则病情好转，相反则病情恶化。结论：重型颅脑损伤后pH值：Pcsfo2、HCO3、ScsfO2越低，其愈后越差。pH值低于7．209以下，本组死亡率75％。观察脑脊液酸碱气体分析对重型颅脑损伤的预后判断有重要意义，同时积极有效地控制颅内压增高及纠正缺血缺氧、纠正酸中毒是抢救重型颅脑损伤的重要环节。The relationship between acidbase gas analysis in the cerebrospinal fluid and prog-nosis was observed in severe craniocerebral injury. Methods: pH value,PO2,PCO2,HCO,and SO2in the cerebrospinal fluid were tested in patients within 24h injury and 3 day after treatment.Results: pH value, PcsfO2, HCO3 and ScsfO2 of patients were decreased hut PcsfCO2 was higherthan that of control after 24h injury, to demonstrate cerebral hypoxia and metablic acidosis. If pHvalue,PcsfO2,HCO3 and ScsfO2 were increased,contrary PcsfCO2 after the third day of treatmentthe patient's condition was good. The results were opposited, the patient's condition was bad.Conclusion: The pH value, PcsfO2, HCO3 and ScsfO2 were greatly decreased after the treatment,the prognosis would be warse pH value was less than 7. 209. The death rate was 75%. Acid-basegas analysis in the cerebrospinal fluid is important on the prognosis,effective controlling increaseof intracranial pressure,correcting cerebral hypoxia and acidosis in patients with severe cranio-cerebral injury.

关 键 词：重型 颅脑损伤 脑脊液 酸碱气体分析 预后 

分 类 号：R651.150.7[医药卫生—外科学]