浓缩红细胞对重型颅脑损伤患者脑组织氧分压的影响  

Effect of packed red blood cell transfusion on brain tissue oxygenation in patients with severe traumatic brain injury

作　　者：王其平[1] 那汉荣[1] 徐裕[1] 蒋剑锋[1] 杨磊[1] 高恒[1] 

机构地区：[1]江阴市人民医院神经外科,江苏省214400

出　　处：《江苏医药》2014年第16期1890-1892,共3页Jiangsu Medical Journal

基　　金：无锡市科技发展指导计划(2009CSZ00966)

摘　　要：目的研究输注浓缩红细胞对重型颅脑损伤患者脑组织氧分压(PbtO2)影响。方法重型颅脑损伤(GCS<8分,Hb 70-90g/L)患者18例,输注浓缩红细胞2个单位20次。观察输注浓缩红细胞前、后4h内PbtO2、Hb浓度、颅内压、脑灌注压和动脉血氧饱和度变化。结果与输血前比较,输注浓缩红细胞后4h内,PbtO2升高(5.3±2.4)mm Hg,Hb浓度升高(11±6)g/L(P<0.05),但颅内压、脑灌注压和动脉血氧饱和度无统计学差异(P>0.05)。多重逐步回归分析显示,Hb浓度与PbtO2呈正相关(R=0.12,95%IC=0.04-0.22,P<0.05)。结论重型颅脑损伤患者早期输注浓缩红细胞能明显升高PbtO2。Objective To observe the effect of packed red blood cell transfusion on brain tissue partial pressure of oxygen（PbtO2）in the patients with severe traumatic brain injury.Methods The packed red blood cells 2units were transfused in 1to 4hours after severe traumatic brain injury（GCS〈8,Hb 70-90g/L）for 20 times in 18 patients.The PbtO2,Hb,intracranial pressure,cerebral perfusion pressure and hemoglobin oxygen saturation（SaO2）were detected before and at 2hours after transfusion.Results Compared to before,the increases in PbtO2 and hemoglobin after transfusion were all significant[（5.3±2.4）mm Hg and（11±6）g/L]（P〈0.05）,but the ICP,cerebral perfusion pressure and SaO2 did not significantly changed after transfusion.The multivariate correlation and regression analysis revealed that the increase of hemoglobin concentration was positively correlated with that of PbtO2（R=0.12,95% CI=0.04-0.22,P〈0.05）.Conclusion Transfusion of packed red blood cells can effectively improve cerebral oxygenation in the patients with severe traumatic brain injury in early stage.

关 键 词：浓缩红细胞 颅脑损伤 脑组织氧分压 

分 类 号：R651[医药卫生—外科学]