脑氧与葡萄糖摄取量变化对重型颅脑损伤患者预后影响的研究  

Changes of cerebral extraction oxygen and glucose affect the prognosis of patients with severe craniocerebral trauma

作　　者：邓峰[1] 吴全理[1] 罗大山[1] 姚业轩[1] 陈群[1] 黄少伟[1] 李齐广[1] 韩方华[1] 潘明远[1] 陈琨[1] 

机构地区：[1]广西北海市人民医院神经外科,广西北海536000

出　　处：《右江民族医学院学报》2008年第5期726-727,共2页Journal of Youjiang Medical University for Nationalities

基　　金：2004年北海市科技局立项课题(北科合字200404007)

摘　　要：目的探讨重型颅脑损伤患者脑氧摄取量(CEO2)及脑葡萄糖摄取量(CEG)的变化规律及对预后的影响。方法选择同期存活超过7天的重型颅脑损伤患者62例,在入院或手术后12h内、第3天、第7天分别同步在颈内静脉球部及股动脉抽取血样进行血气分析及血糖检查,计算出CEO2及CEG,对存活病人及死亡病人进行对比分析。结果存活47例,死亡15例。在伤后12h内存活组及死亡组的CEO2、CEG差异无显著性(P均>0.05),第3天起出现进行性下降;第7天死亡组病人的CEO2和CEG均显著低于存活组(P均<0.01)。结论对重型颅脑损伤患者实施动态监测CEO2及CEG,对正确掌握病情、估计预后和指导抢救治疗具有重要意义。Objective To explore the change patterns of cerebral extraction of oxygen （CEO2） and cerebral extraction of glucose （.CEG） and their influence on the prognosis oi patients with severe craniocerebral trauma. Methods Sixty- two patients with severe head injury survived over 7 days after injury were selected in this study. Their blood samples were collected from internal carotid veins and femoral artery at 12 hours, on day3 and day 7 after injury. The data of CEO2 and CEG were obtained via blood gas analysis and blood sugar measurement, and compared these data between alive patients and the dead ones. Results 47 patients survived and 15 patients were dead. In 12 hours after injury, in comparison of CEO2 and CEG between the living patients and the dead ones, there were no statistical differences （all P values 〉0.05）, from day 3, CEO2 and CEG decreased gradually, on day 7, CEO2 and CEG in dead patients were statistically lower than those in the living ones （all P values 〈 0.01） Conclusion Dynamic monitoring CEO2 and CEG in patients with severe head injury can reflect cerebral cell＇s oxygen and sugar metabolic function and clinical condition. CEO2 and CEG can guide clinical treatment and have prognostic values in patients with severe head injury.

关 键 词：颅脑损伤 脑氧摄取量 脑葡萄糖摄取量 

分 类 号：R651.15[医药卫生—外科学]