Реферат
Objective To investigate the effect ofhyperventilation on cerebral blood flow,brain metabolism and cerebral perfusion in patients with traumatic brain injury by end tidal pressure of CO2 (PETCO2) monitoring.Methods Seventy patients with traumatic brain injury,admitted to our hospital from January 2009 to June 2012 and performed decompressive craniectomy,were chosen in our study; they were randomly divided into group A and group B (n=35); patients in the group A accepted PETCO2 within 20-25 mm Hg and arterial partial pressure of carbon dioxide (PaCO2) within 22-25 mm Hg,and patients in the group B received PETCO2 within 25-30 mm Hg and PaCO2 within 30-45 mm Hg.The blood gas pressure,mean artery pressure,cerebral oxygen partial pressure,cerebral perfusion pressure,cerebral oxygen supply and demand balance,and changes of neuron specific enolase (NSE),glucose and lactic acid were compared between the two groups at the beginning of craniectomy.Results The PaCO2 level,mean artery pressure,intracranial pressure,and levels of NSE,glucose and lactic acid in group A were significantly lower than those in group B (P＜0.05); while the brain oxygen partial pressure,cerebral perfusion pressure,arterial oxygen content (CaO2),venous oxygen content (CjvO2) and cerebral oxygen uptake rate (CERO2) showed no significant difference between the two groups (P＞0.05).Conclusion PETCO2 controlling within 20-25 mm Hg can effectively maintain the cerebral blood perfusion and cerebral oxygen supply and demand balance of the patients; it can also reduce the pathological metabolite effect on the brain tissue; therefore,its clinical value is worthy for attention.