高血压脑出血患者手术前后局部脑组织氧饱和度的变化及对患者病情及预后的影响  

Changes of Regional Cerebral Oxygen Saturation in Patients with Hypertensive Intracerebral Hemorrhage before and after Operation and Its Effect on Patients' Condition and Prognosis

作　　者：丁昊[1] 邓琳[1] 陈岷辉[1] 陈立坷[1] 李涛[1] Ding Hao;Deng Lin;Chen Minhui(Department of Neurosurgery and neurology,The Fourth People′s Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院神经外科,神经内科,四川自贡643000

出　　处：《四川医学》2018年第10期1104-1107,共4页Sichuan Medical Journal

基　　金：四川省卫生计生委科研课题资助项目(编号:140110)

摘　　要：目的研究高血压脑出血患者手术前后局部脑组织氧饱和度(regional cerebral oxygenation,rScO_2)的变化及对患者病情及预后的影响。方法对纳入研究的27例高血压脑出血患者采用近红外光谱技术(near infrared spectroscopy technology,NIRS)检测手术前后rScO_2水平,对手术前后rScO_2的变化进行分析。患者随访至术后6月,以日常生活能力Barthel指数判断,术后6月内死亡及术后6月Barthel指数在40分以下者,归入预后差组,术后6月Barthel指数在40分以上者归为预后良好组,分别比较两组患者术前、术后rScO_2水平,以及rScO_2变化情况。结果高血压脑出血患者手术后rScO——2(62.81±3.94)较手术前(60.11±3.21)有明显升高,恢复良好组与恢复差组术前rScO_2无统计学差异,术后恢复良好组rScO_2水平(65.23±2.57)较恢复差组(60.87±3.81)升高明显。结论手术能明显提高高血压脑出血患者rScO_2水平,术前、术后rScO_2的变化水平对患者的预后判断有潜在价值。Objective To study the changes of regional cerebral oxygenation(rScO2)before and after operation in patients with hypertensive intracerebral hemorrhage and its influence on patients condition and prognosis.Methods The changes of rScO2 in 27 patients with hypertensive intracerebral hemorrhage before and after operation were measured by near infrared spectroscopy technology(NIRS),and the changes of rScO2 before and after operation were analyzed.The patients were followed up to 6 months after operation.According to Barthel index of daily living ability,those who died within 6 months after operation and those whose Barthel index was below 40 at 6 months after operation were classified as poor prognosis group,while those whose Barthel index was above 40 at 6 months after operation were classified as good prognosis group.Preoperative and postoperative rScO2 levels and rScO2 changes were compared between the two groups.Results The rScO2 of patients with hypertensive intracerebral hemorrhage after operation(62.81±3.94)was significantly higher than that before operation(60.11±3.21),no significant difference in preoperative rScO 2 between good recovery group and poor recovery group.And the rScO2 level in the group with good postoperative recovery(65.23±2.57)was significantly higher than that in the poor recovery group(60.87±3.81).Conclusion Surgery can significantly improve the level of rScO2 in patients with hypertensive intracerebral hemorrhage,and the changes of rScO 2 levers before and after surgery have potential value for the prognosis of patients.

关 键 词：高血压脑出血 局部脑氧饱和度 手术 预后 

分 类 号：R755[医药卫生—皮肤病学与性病学]