集束化综合脑保护治疗对重型颅脑损伤患者脑氧代谢、内皮素及颅内压的影响  

Effect of bundle comprehensive brain protection treatments on cerebral oxygen metabolism, endothelin and intracranial pressure of patients with severe craniocerebral trauma

作　　者：徐兰娟[1] 李保林[1] 吴琼[1] 李成建[1] 

机构地区：[1]郑州大学附属郑州中心医院重症医学科,郑州450007

出　　处：《中华神经医学杂志》2017年第7期706-710,共5页Chinese Journal of Neuromedicine

基　　金：郑州市科技人才队伍建设计划-科技创新团队（131PCXTD626）

摘　　要：目的探讨集束化综合脑保护治疗策略对重型颅脑损伤的治疗影响。方法选取自2014年1月至2016年11月郑州大学附属郑州中心医院重症医学科（ICU）收治的急诊术后重型颅脑损伤患者120例。依据治疗方法不同将其分为对照组和观察组，每组60例。对照组给予常规标准化治疗，观察组给予集束化综合脑保护治疗。观察并比较2组患者治疗前、治疗5d后脑氧代谢指标[颈静脉球部血氧饱和度（SjVO2）、脑氧摄取量（CEOO、动静脉氧含量差（A-VDO2）]、内皮素（ET）以及颅内压（CP）水平的变化。结果治疗前2组患者脑氧代谢指标及ET、ICP水平差异均无统计学意义（P〉0．05）。治疗后观察组SjVO2、CEO2、AVDO2水平均显著高于对照组，ET以及ICP水平显著低于对照组。差异均有统计学意义（P〈0．05）。结论集束化综合脑保护治疗能明显改善重型颅脑损伤患者的脑氧代谢．降低血浆ET水平．改善血管内皮功能．降低ICP，具有重要的临床实践价值。Objective To explore how the bundle comprehensive brain protection treatments affects cerebral oxygen metabolism, endothelial cell function and intracranial pressure of patients with severe craniocerebral trauma. Methods One hundred and twenty patients with severe craniocerebral trauma were selected from January 2014 to November 2016 in our hospital. The patients were randomly divided into control group and observation group （n=60）. Patients from the control group were given normal treatment; whilst patients from the observation group were additionally treated with bundle comprehensive brain protection treatments. The cerebral oxygen metabolism levels （jugular bulb venous oxygen saturation [SjVO2], cerebral extraction of oxygen [CEO~] and arteriovenous oxygen difference [AVDO2]）, endothelin （ET） level and intracranial pressure （ICP） were calculated and compared before and after treatment. Results The levels of SjVOz, CEO2 and AVDO2, and ET and ICP levels showed no significant differences between the obvseration group and control group before treatment （P〉0.05）. After treatment, the levels of SjVO2, CEO2 and AVDO2 in the observation group were significantly higher than those in the control group （P〈0.05）; as compared with those in the control group, the ET and ICP levels in the observation group were significantly decreased （P〈0.05）. Conclusion The bundle comprehensive brain protection treatments could improve cerebral oxygen metabolism and endothelial function, and decrease the ET and ICP levels of patients with severe craniocerebral trauma, which has important value in clinical practice.

关 键 词：颅脑损伤 集束化 综合脑保护 

分 类 号：R651.15[医药卫生—外科学]