Bruzzone P, Dionigi R, Bellinzona G, Imberti R, Stocchetti N
Servizio di Anestesia e Rianimazione, IRCCS Policlinico S. Matteo, Pavia, Italy.
Acta Neurochir Suppl. 1998;71:111-3. doi: 10.1007/978-3-7091-6475-4_33.
Ischemia causes secondary brain damage after severe head injury (SHI). Cerebral perfusion is commonly estimated by monitoring CPP, but the adequacy of cerebral oxygenation requires further measurements, such as jugular oxygen saturation or, more recently, PtiO2 monitoring. In 7 patients with severe head injury, ICP, MAP, CPP, SjO2 and PtiO2 were monitored for a mean time of 9.0 +/- 2.2 days. Most of the data were in a "normal" range. Focusing on values under the thresholds of 60 mm Hg for CPP and 20 mm Hg for PtiO2, we found a relationship between CPP and PtiO2. Looking at the PtiO2 time-course, we observed a quite constant increasing trend during the first 48 hours of monitoring, then the values remained relatively constant within a normal range. Our data show that decreases of PtiO2 are not uncommon after severe head injury and therefore it seems that monitoring of PtiO2 in SHI may be useful in order to minimize secondary insults.
缺血会在重度颅脑损伤（SHI）后导致继发性脑损伤。通常通过监测脑灌注压（CPP）来评估脑灌注情况，但脑氧合是否充足还需要进一步测量，如颈静脉血氧饱和度，或者最近的脑组织氧分压（PtiO2）监测。对7例重度颅脑损伤患者进行了监测，监测指标包括颅内压（ICP）、平均动脉压（MAP）、脑灌注压（CPP）、颈静脉血氧饱和度（SjO2）和脑组织氧分压（PtiO2），平均监测时间为9.0±2.2天。大多数数据处于“正常”范围。关注脑灌注压低于60 mmHg以及脑组织氧分压低于20 mmHg的数值，我们发现了脑灌注压与脑组织氧分压之间的关系。观察脑组织氧分压的时间进程，我们发现在监测的前48小时内有相当稳定的上升趋势，然后这些数值在正常范围内保持相对稳定。我们的数据表明，重度颅脑损伤后脑组织氧分压降低并不罕见，因此，在重度颅脑损伤中监测脑组织氧分压可能有助于将继发性损伤降至最低。
