血液稀释疗法对重型颅脑创伤患者脑组织氧分压及预后的影响

摘要

Objective To discuss the effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma. Methods A total of 42 cases of severe craniocerebral trauma were randomized divided into two groups, ie, control group and treatment group, to observe the changes of brain tissue oxygen pressure ( PbtO2 ) , hematocrit (HCT) and 6-month Glasgow outcome scale (COS) after injury. Then, PbtO2, HCT and GOS were compared between two groups. Restilts ( 1 ) There was a positive correlation between PbtO2 and HCT when HCT was lower than 0.25( r =0. 732 ,P ＜0. 001 ) in the treatment group; while a negative correlation was found between PbtO2 and HCT when HCT was higher than 0.25(r = - 0. 698 ,P＜0. 001 ). (2) Compared with control group, the index of brain tissue oxygen in treatment group was obviously higher ( t = 2.27, P = 0. 029 ) , with better prognosis (X2= 5.09, P ＜ 0.05 ). Conclusion Hemodilution can significantly increase brain tissue oxygen supply and improve the prognosis of cases of severe craniocerebral trauma.%目的 探讨血液稀释疗法对重型颅脑创伤(severe traumatic brain injury,Stbi)患者脑组织氧分压及预后的影响.方法 42例Stbi患者随机分为治疗组和对照组,观察每组患者红细胞压积(HCT)、脑组织氧分压(PbtO2)的变化及6个月GOS,比较两组患者HCT、PbtO2、GOS评分情况. 结果 (1)治疗组HCT＜0.25时,PbtO2与HCT呈正相关(r=0.732,P＜0.01);HCT≥0.25时,PbtO2与HCT呈负相关(r=-0.698,P＜0.01).(2)与对照组比较,治疗组PbtO2明显升高(t=2.27,P=0.029),预后明显改善(x2=5.09,P＜0.05).结论 血液稀释疗法可以明显提高脑组织的供氧,改善STBI患者的预后.