近红外光谱无创监测局部脑氧饱和度在重型颅脑损伤术后治疗中的应用研究  

Application of noninvasive monitoring of regional cerebral oxygen saturation in the treatment of severe brain injury in the postoperative by near infrared spectroscopy

作　　者：唐剑[1] 周和平[1] 王绍波[1] 陈新生[1] TANG Jian ZHOU Heping WANG Shaobo CHEN Xinsheng(Department of Neurosurgery,Anqing Affiated Hospital of Anhui Medical University,Anqing,Anhui 246000, Chin)

机构地区：[1]安徽医科大学附属安庆医院神经外科,安徽安庆246000

出　　处：《安徽医药》2017年第6期1036-1039,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽医科大学校科学研究基金(2015xkj146)

摘　　要：目的探讨近红外光谱技术(NIRS)实时无创监测重型颅脑损伤术后局部脑氧饱和度(rScO_2)的变化规律以及与颅内压(ICP)之间的相关性。方法选择24例重度颅脑损伤急诊术后病人,采用近红外光谱与有创颅内压监测仪持续监测rScO_2、ICP,同时记录脉氧饱和度(SpO_2)、平均动脉压(MAP)、脑灌注压(CPP),采用SPSS统计学方法分析监测结果的关联性。结果重度颅脑损伤预后程度和rScO_2差异有统计学意义,预后越好的组其rScO_2值越高,术后rScO_2早期会出现下降,最后随颅内高压缓解后再次呈上升趋势。但4例死亡病人伤后rScO_2主要呈下降趋势,上升不明显。rScO_2与ICP呈显著负相关(r=-0.882,P<0.001),rScO_2与CPP呈显著正相关(r=0.938,P<0.001)。结论近红外光谱技术可以准确无创监测脑组织rScO_2,对于重型颅脑损伤治疗及预后评估有着重要意义。Objective To investigate the changes of regional cerebral oxygen saturation （ rSc0 2） in patients with severe brain injury af-ter operation which were continuously monitored by near infrared spectroscopy （NIRS） and the correlation between the changes of re-gional cerebral oxygen saturation and intracranial pressure （ICP）. Methods Twenty four patients with severe brain injury after emer-gency operation were given continuously monitoring of regional cerebral oxygen saturation and intracranial pressure by near infrared spectroscopy and invasive intracranial pressure monitor. Meanwhile pulse oxygen saturation （ Sp02 ）,mean arterial blood pressure （MAP） and cerebral perfusion pressure （ CPP） were monitored. The correlation of monitoring results was analyzed by SPSS statistics a-nalysis. Results The prognosis of severe brain injury and rSc02 statistically significant. The rSc02 reduced in the early postoperative period. As the intracranial pressure relieves it increases. But the rSc02in 4 cases of death decline as others subsequently it increased while the ascending trend was not obvious. A significant negative correlation between the rSc02 and ICP （r = - 0. 882,P 〈0. 001） , and a positive correlation between the rSc02 and CPP （r =0. 938 ,P 〈0. 001） . Conclusions Near infrared spectroscopy technology can ac-curately noninvasive monitoring of regional cerebral oxygen saturation,which is of great significance for the treatment and prognosis of patients with severe brain injury.

关 键 词：近红外光谱 无创监测 脑局部氧饱和度 重型颅脑损伤 颅内压 

分 类 号：R651.15[医药卫生—外科学]