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目的探讨重型颅脑创伤(severe traumatic brain injury,sTBI)患者亚低温治疗中(mild hypothermia treatment,MHT)持续颈静脉血氧饱和度(jugularn venous oxygen saturation,S_(jv)O_2)监测的意义。方法对36例sTBI患者进行持续脑组织氧分压(P_(bt)O_2)、颅内压和S_(jv)O_2监测,并对监测结果及P_(bt)O_2与S_(jv)O_2的相关性进行分析。结果(1)36例sTBI患者在伤后24h内、36h和48h P_(bt)O_2与颅内压呈负相关(r=-0.978,P＜0.05),颅内压与S_(jv)O_2呈负相关(r= -0.947,P＜0.05),P_(bt)O_2与S_(jv)O_2呈直线正相关(r=0.965,P＜0.05)。(2)S_(jv)O_2降低患者比S_(jv)O_2正常患者预后差,而S_(jv)O_2异常增高患者的预后比S_(jv)O_2降低患者的预后更差；在一定范围内,随着S_(jv)O_2的增加,患者预后明显改善(P＜0.05)。结论S_(jv)O_2能监测大脑半球氧代谢状况,且对指导患者治疗及判断预后具有重要意义。
Objective To investigate the significance of continuous jugular ventricular oxygen saturation (SjvO2) monitoring in mild hypothermia (MHT) patients with severe traumatic brain injury (sTBI). Methods Thirty - six patients with sTBI underwent continuous cerebral oxygenation (P_ (bt) O_2), intracranial pressure and S_ (jv) O_2 monitoring. The monitoring results and the correlation between P_ (bt) O_2 and S_ (jv) O_2 Sex analysis. Results (1) There was a negative correlation between P_ (bt) O_2 and intracranial pressure in 36 patients with sTBI at 24h, 36h and 48h (r = -0.978, P <0.05) and intracranial pressure and S_ (jv) O_2 (R = -0.947, P <0.05). There was a linear positive correlation between P_ (bt) O_2 and S_ (jv) O_2 (r = 0.965, P <0.05). (2) The prognosis of patients with Sj (jv) O_2 decreased worse than that of normal patients with Sj (jv) O_2, while the prognosis of patients with abnormal increase of SjvO_2 was worse than that of patients with decreased SjvO_2. With the increase of S_ (jv) O_2, the prognosis of patients was significantly improved (P <0.05). Conclusion S_ (jv) O_2 can monitor the hemoglobin metabolism in the hemisphere and is of great importance in guiding patients to treat and prognosis.