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目的 :探讨动脉瘤术中进行脑组织氧代谢监测的临床意义。方法 :2 0 0 0年 10月～ 2 0 0 2年 7月间对 2 0例颅内动脉瘤患者行动脉瘤夹闭术 ,术中对载瘤动脉进行临时阻断 ,并对被阻断动脉供血区持续进行脑组织氧代谢监测 ,比较临时阻断载瘤动脉前后PbtO2 、PbtCO2 和pH的变化。结果 :载瘤动脉临时阻断后 ,PbtO2 从 (2 2± 3)mmHg下降到 (14± 2 )mmHg(P >0 .0 1) ,PbtCO2 从 (4 6± 2 )mmHg升高到 (5 4± 3)mmHg(P >0 .0 1) ,pH从 7.10± 0 .0 3下降到 7.0 2± 0 .0 2 (P >0 .0 1)。而且 ,上述指标均在临时夹闭后 30s内就发生明显的变化。结论 :脑组织氧代谢监测是一种安全、可靠、灵敏的监测手段 ,可及时准确地发现因载瘤动脉被阻断而引起的脑组织缺血缺氧 ,并有助于术者调整临时阻断时间 ,从而防止临时阻断动脉造成医源性脑缺血损害。
Objective: To investigate the clinical significance of monitoring oxygen metabolism in brain tissue during aneurysm surgery. METHODS: From October 2000 to July 2002, 20 aneurysms of aneurysm were performed aneurysm occlusion. The intra-arterial artery was blocked temporarily during operation and was blocked The arterial blood supply areas were continuously monitored for oxygen metabolism in the brain tissue. The changes of PbtO2, PbtCO2 and pH before and after the temporary occlusion of the parent artery were compared. Results: PbtO2 decreased from (22 ± 3) mmHg to (14 ± 2) mmHg (P> 0.01) and PbtCO2 increased from (46 ± 2) mmHg to (5 4 ± 3) mmHg (P> 0. 01), the pH decreased from 7.10 ± 0. 0 3 to 7.0 2 ± 0. 0 2 (P> 0. Moreover, the above indicators were significantly changed within 30s after the temporary clamping. Conclusion: The monitoring of oxygen metabolism in brain tissue is a safe, reliable and sensitive monitoring method, which can detect the ischemia and hypoxia of brain tissue caused by the occlusion of the parent artery in time and accurately, and help the surgeon adjust the temporary resistance Off time, thereby preventing the temporary occlusion of arteries causing iatrogenic ischemic damage.