过度通气对62例重型颅脑损伤的临床观察

目的 研究过度通气对重型颅脑损伤（STBI）患者颅内压（ICP）,脑氧摄取,血清神经元特异性烯醇化酶（NSE）含量的影响.方法 62例重型颅脑损伤患者（GCS≤8分）,随机分成治疗组和对照组,治疗组采用过度通气使呼气末二氧化碳分压（PetPaCO,）维持在（4～4.67kPa）2h,同时监测颅内压,颈静脉氧饱和度（SjvO2）,动脉血氧饱和度（SaO2）.结果 重型颅脑损伤的患者行过度通气2h后,ICP有不同程度的下降,平均下降（0.53 kPa）,脑氧摄取与血清NSE含量没有统计学差异.结论 轻度过度通气有效地降低了颅内压,没有导致脑组织缺血缺氧及脑组织损伤,不能放弃这种简单有效的降低颅内压方法.

Clinical observation of 62 cases during hyperventilation in patients with severe traumatic brain injury

Objective： The study of severe traumatic brain injury （STBI） was to investigate the effects of hyperventilation on intracranial pressure （ICP）, brain extraction oxygen, serum neuron- specific enolase（NES）. Methods 62 patients（GCS 〈 8） with severe traumatic brain injury were divided into treatment and control groups at random, keeping end-tidal carbon dioxide pressure （PetPaCO2 ） at 4-4. 67kPa for 2 hours by hyperventilation in treatment groups, simultaneously monitoring intracranial pressure saturation of jugular venous oxygen （SjvO2 ）, saturation of arterial oxygen（ SaO2 ）. Results ICP had declined by varying degrees （average 0.53 kPa）. There were no statistics differences both SaO2 and serum NES. Conclusions Mild hyperventilation effectively reduced ICP, did not result in brain tissues of hypoxic-isehemic injury. Do not giving up such a simple and effective method of reducing ICP.