组织氧分压结合颅内压监测在急性重型颅脑损伤合并多发伤目标治疗的应用及预后分析
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Application and prognosis of brain tissue oxygenation combined with in-tracranial pressure monitoring in treat-to-target for acute severe traumat-ic brain injury with multiple injuries
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    摘要:

    目的:分析脑组织氧分压(PbtO2)结合颅内压(ICP)监测在急性重型颅脑损伤(sTBI)合并多发伤目标治疗的应用及其与预后的关联。方法:选取78例sTBI合并多发伤患者为研究对象,按照治疗方法的不同分为对照组(接受ICP监测治疗,n=39)和观察组(接受ICP联合PbtO2监测治疗,n=39)。比较两组脑相关参数,并分析患者预后。结果:观察组7 d内ICP、颅内高压占比、甘露醇使用总量均低于对照组,脑灌注压高于对照组(P<0.05);观察组预后良好占比、6个月累计生存率均高于对照组(P<0.05);观察组PbtO2值与格拉斯哥预后评分正相关(P<0.05)。结论:PbtO2结合ICP监测下在sTBI合并多发伤治疗中具有显著价值,可较好反映患者脑部缺氧缺血状态,对患者短期预后具有改善作用。

    Abstract:

    Objective:To analyze the application and prognosis of brain tissue oxygenation(PbtO2)combined with in-tracranial pressure(ICP)monitoring in treat-to-target for acute severe traumatic brain injury(sTBI)with multiple injuries.Methods:A total of 78 patients with sTBI and multiple injuries were selected.They were divided into the control group(receiv-ing ICP monitoring,n=39)and the observation group(receiving ICP combined with PbtO2 monitoring,n=39)according to different treatment methods.The brain-related parameters were compared between the two groups,and the prognosis was eval-uated.Results:The average ICP within 7 days,proportion of patients with intracranial hypertension,and total dosage of mannitol in the observation group were lower than those in the control group,while the average cerebral perfusion pressure was higher than that in the control group(P<0.05).The proportion of patients with good prognosis and 6-month accumulative survival rate in the observation group were higher than those in the control group(P<0.05).The average PbtO2 was positively correla-ted with glasgow outcome score in the observation group(P<0.05).Conclusion:PbtO2 combined with ICP monitoring is of high value in the treatment of sTBI with multiple injuries.It can well reflect the status of cerebral hypoxia and ischemia in pa-tients and improve the short-term prognosis.

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李国平;杨林;符江;李之令;.组织氧分压结合颅内压监测在急性重型颅脑损伤合并多发伤目标治疗的应用及预后分析[J].川北医学院学报,2025,40(9):1200-1204.

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  • 在线发布日期: 2025-10-14
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