Meixensberger J, Dings J, Kuhnigk H, Roosen K
Department of Neurosurgery, University of Würzburg, Federal Republic of Germany.
Acta Neurochir Suppl (Wien). 1993;59:58-63. doi: 10.1007/978-3-7091-9302-0_10.
Brain cortex PO2 was measured after craniotomy and opening of the dura mater in 26 patients. We determined the brain tissue PO2 under standard narcotic conditions and after changing arterial PO2 and PCO2. Patients were divided into two groups (normal and pathological), depending on the aspect of their cortex on Ct/MRI and intraoperative appearance of the cortex. No statistical significantly difference was seen between tissue PO2 of the normal and the pathological group. A significant difference was seen only between the normal group and a subgroup with brain swelling (p = 0.0344). In the normal group no correlation was seen between tissue PO2 and arterial PO2 (r = 0.1541, p = 0.3076), whereas in the pathological group and especially in the oedema subgroup there was a highly significant correlation between tissue PO2 and PaO2 (r = 0.754, p = 0.0015 and r = 0.888, p = 0.0007). Breathing 100% oxygen changed tissue PO2 to 137.8 or 352 mmHg in the normal or the pathological group, respectively. Again, there was no correlation between tissue PO2 and PaO2 in the normal group (r = 0.1071, p = 0.392), whereas this correlation was significant in the pathological and the oedema subgroup (r = 0.6291, p = 0.0473 and r = 0.8385, p = 0.0185). This is evidence for regulatory mechanisms of tissue PO2. During hyperventilation no significant difference in tissue PO2 between the normal and the pathological group was seen. Low tissue PO2 values, however, indicate a risk for inducing ischemia.
在26例患者开颅并打开硬脑膜后测量脑皮质PO2。我们在标准麻醉条件下以及改变动脉PO2和PCO2后测定脑组织PO2。根据患者皮质在CT/MRI上的表现以及术中皮质外观,将患者分为两组(正常组和病理组)。正常组和病理组的组织PO2之间未见统计学显著差异。仅在正常组与脑肿胀亚组之间观察到显著差异(p = 0.0344)。在正常组中,组织PO2与动脉PO2之间未见相关性(r = 0.1541,p = 0.3076),而在病理组尤其是水肿亚组中,组织PO2与PaO2之间存在高度显著相关性(r = 0.754,p = 0.0015和r = 0.888,p = 0.0007)。正常组或病理组呼吸100%氧气分别使组织PO2变为137.8或352 mmHg。同样,正常组中组织PO2与PaO2之间无相关性(r = 0.1071,p = 0.392),而在病理组和水肿亚组中这种相关性显著(r = 0.6291,p = 0.0473和r = 0.8385,p = 0.0185)。这是组织PO2调节机制的证据。在过度通气期间,正常组和病理组之间的组织PO2未见显著差异。然而,低组织PO2值表明有诱发缺血的风险。