常诚 边世春 李健 孙奇

【摘要】 目的：觀察颅脑外伤患者脑灌注指标及脑氧代谢的变化情况。方法：选取2016年2月-2020年

10月的100例颅脑外伤患者为观察组，同时期的100例非神经系统损伤手术患者为对照组。比较两组脑灌注指标（rCBF、rCBV、MTT及TTP）及脑氧代谢（氧供及氧耗）指标，并比较观察组不同颅脑损伤分级患者的检测结果，采用Spearman秩相关分析脑灌注指标及脑氧代谢指标与颅脑损伤分级的关系。结果：观察组rCBF、rCBV均显著低于对照组，MTT、TTP及脑氧代谢指标均显著高于对照组，观察组不同颅脑损伤分级患者脑灌注指标及脑氧代谢指标比较，差异均有统计学意义（P<0.05）。Spearman秩相关分析显示，rCBF、rCBV与颅脑损伤分级均呈负相关，MTT、TTP及脑氧代谢指标与颅脑外伤分级均呈正相关（P<0.001）。结论：颅脑外伤患者的脑灌注指标及脑氧代谢的变化突出，且与颅脑损伤分级有密切的关系，因此在颅脑外伤患者中的检测价值较高。

【关键词】 颅脑外伤 脑灌注指标 脑氧代谢

Observation on Changes of Cerebral Perfusion Indexes and Cerebral Oxygen Metabolism of Patients with Craniocerebral Trauma/CHANG Cheng， BIAN Shichun， LI Jian， SUN Qi. //Medical Innovation of China， 2021， 18（33）： -172

[Abstract] Objective： To observe the change situation of cerebral perfusion indexes and cerebral oxygen metabolism of patients with craniocerebral trauma. Method： A total of 100 patients with craniocerebral trauma from February 2016 to October 2020 were chosen as the observation group， 100 surgical patients with

non-nervous system injury at the same time were chosen as the control group. Then the cerebral perfusion indexes （rCBF， rCBV， MTT and TTP） and cerebral oxygen metabolism （oxygen supply and oxygen consumption） indexes of two groups were compared， then the detection results of the observation group with different classifications of craniocerebral trauma were compared， then the correlation between cerebral perfusion indexes， cerebral oxygen metabolism indexes and classifications of craniocerebral trauma were analyzed by Spearman rank correlation analysis. Result： The rCBF and rCBV of the observation group were significantly lower than those of the control group， the MTT， TTP and cerebral oxygen metabolism indexes were significantly higher than those of the control group， the cerebral perfusion indexes and cerebral oxygen metabolism indexes of the observation group with different classifications of craniocerebral trauma were compared， there were statistically significant differences （P<0.05）. Spearman rank correlation analysis showed rCBF and rCBV were negatively correlated with classifications of craniocerebral trauma， MTT， TTP and cerebral oxygen metabolism indexes were positively correlated with classifications of craniocerebral trauma （P<0.001）. Conclusion： The changes of cerebral perfusion indexes and cerebral oxygen metabolism of patients with craniocerebral trauma are obvious， and they have close relationship to the classifications of craniocerebral trauma， so their detection value in the patients with craniocerebral trauma are higher.

[Key words] Craniocerebral trauma Cerebral perfusion indexes Cerebral oxygen metabolism

First-author’s address： The 985th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army， Taiyuan 030001， China

doi：10.3969/j.issn.1674-4985.2021.33.041

颅脑外伤在临床并不乏见，其对患者神经系统造成的损伤较大，重症患者预后较差。临床与颅脑损伤相关的研究中，脑血供状态是研究的常见及重点方面，而脑灌注指标在反映脑血流量方面有积极的作用，但是其在颅脑外伤患者中的检测研究存在一定差异[1-2]。另外，脑氧代谢对于脑耗氧量及功能代谢等方面具有较好地反映作用，其在颅脑外伤患者中的变化不足。鉴于上述情况的存在，本研究就颅脑外伤患者脑灌注指标及脑氧代谢的变化情况进行观察与研究，现报道如下。……