颅脑外伤术后脑氧代谢监测方法研究进展

摘要

颅脑外伤是现代社会共同面对的治疗难题,一直是青少年死亡和致残的主要原因.在颅脑外伤治疗过程中,预防和减少继发性脑损伤显得尤为重要.因此,严密监测脑功能,尤其是脑氧代谢平衡,早期发现脑灌注不足、脑组织用氧障碍,及时给予干预可以降低病死率同时减轻神经系统后遗症.当前脑氧代谢的监测方法包括颈静脉球血氧饱和度、近红外光谱技术经颅脑氧饱和度、脑组织氧分压、脑微量透析等.该文通过临床实践结合国内外最新研究进展对以上几种监测手段进行描述,总结各种脑氧代谢监测手段的特点,旨在为临床工作者提供参考,以期更好地改善颅脑外伤患者的预后.%Traumatic brain injury(TBI) can lead to high mortality and disability in children,and can cause great difficulties in treatment worldwide.It is important to prevent and reduce the secondary brain injuries.Therefore,monitoring the brain function,especially the balance of cerebral oxygen metabolism seems to play a very extraordinary role.The mortality and the neurologic sequelae can be improved as long as we detect the cerebral hypoperfusion at the early stage and give timely interventions.Now,the popular monitoring methods include jugular bulb oxygen saturation,regional cerebral oxygen saturation by near infrared spectroscopy,brain tissue oxygen pressure,and cerebral microdialysis.This review aims to summarize the clinical practice of the cerebral oxygen metabolism monitoring methods in TBI children by reviewing the latest research literatures at home and abroad and to provide reference for clinicians to ameliorate the prognosis.