Suehiro Eiichi, Fujisawa Hirosuke, Koizumi Hiroyasu, Nomura Sadahiro, Kajiwara Koji, Fujii Masami, Suzuki Michiyasu
Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Neurol Med Chir (Tokyo). 2011;51(8):551-5. doi: 10.2176/nmc.51.551.
The differences between brain and bladder temperature (delta T), and the relationship of delta T to cerebral perfusion pressure (CPP) and jugular venous oxygen saturation (SjO(2)) were studied during hypothermia in 11 patients with severe traumatic brain injury, of whom 5 underwent conservative treatment for diffuse axonal injury (DAI) (DAI group) and 6 who underwent decompressive craniectomy for hematoma (SDH group). All patients underwent hypothermia treatment. Brain temperature was monitored via an intraparenchymal catheter. Bladder temperature was used as the core temperature. SjO(2) was measured continuously. The outcome of all patients was evaluated at discharge using the Glasgow Outcome Scale. Delta T in the SDH group was significantly lower than that in the DAI group. No relationship was found between delta T and CPP during the investigation period. A significant correlation between delta T and SjO(2) was seen in the DAI group, but not in the SDH group. Decompressive craniectomy affects the brain temperature through external environmental factors. Measurement of brain temperature may be a reliable indicator of cerebral blood flow and brain metabolism in patients with DAI and closed cranium during hypothermia. Further experience is required to test this proposal.
对11例重型颅脑损伤患者在低温治疗期间脑与膀胱温度的差值（ΔT），以及ΔT与脑灌注压（CPP）和颈静脉血氧饱和度（SjO₂）的关系进行了研究，其中5例因弥漫性轴索损伤（DAI）接受保守治疗（DAI组），6例因血肿接受去骨瓣减压术（SDH组）。所有患者均接受低温治疗。通过脑实质内导管监测脑温。膀胱温度作为核心温度。连续测量SjO₂。所有患者出院时使用格拉斯哥预后量表进行评估。SDH组的ΔT显著低于DAI组。在研究期间未发现ΔT与CPP之间存在关联。DAI组中ΔT与SjO₂之间存在显著相关性，但SDH组中未发现。去骨瓣减压术通过外部环境因素影响脑温。在低温治疗期间，测量脑温可能是DAI和闭合性颅骨患者脑血流和脑代谢的可靠指标。需要更多经验来验证这一观点。
