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目的观察颈内静脉血氧利用率(O2UC);颈内静脉血二氧化碳、乳酸与动脉血净差值(VAPCO2,VALa)在早期重型颅脑损伤病人中变化及评价它们反映全脑氧代谢改变中的意义。方法比较颈内静脉血二氧化碳、乳酸与动脉血差值(VAPCO2、VALa)、氧利用率(O2UC)在病情轻重间差别。结果①重型、轻中型颅脑损伤病人颈内静脉血VAPCO2均为正值,且轻型病人增加量较重型多,两者比较差异有统计学意义,P<0.05;VALa重型病人颈内为负值,轻中型病人均为正值,两组比较差异有统计学意义,P<0.05。O2UC数值重型组比轻中型组小,两两比较差异有统计学意义,P<0.05。结论重型颅脑损伤病人表现为低O2UC、低VAPCO2、负VALa,是早期颅脑损伤病情极重的标志。颈内静脉血血气、乳酸监测全脑氧代谢变化有临床价值。
Objective To observe the blood oxygen utilization rate (O2UC) of the internal jugular vein (ICU). The changes of carbon dioxide (CO2), the net difference between lactic acid and arterial blood (VAPCO2, VALa) in patients with severe craniocerebral trauma and their changes in whole brain oxygen metabolism Meaning. Methods The differences in the severity of illness between carbon dioxide in jugular venous blood, VAPCO 2, VALa and oxygen utilization rate (O 2UC) were compared. Results ① The VAPCO2 in patients with severe, mild and moderate traumatic brain injury was positive, and the patients with mild disease were more severe and more severe, P <0.05; negative in the neck of VALa patients , Light and medium-sized patients were positive, the difference between the two groups was statistically significant, P <0.05. The O2UC numerically severe group was smaller than the mild medium group, and the difference was statistically significant (P <0.05). Conclusions Patients with severe craniocerebral injury show low O2UC, low VAPCO2 and negative VALa, which are extremely severe signs of early craniocerebral injury. Jugular vein blood gas, lactate monitoring whole brain oxygen metabolism changes have clinical value.