【摘要】 目的 探讨脑氧摄取率（CERO₂）、脑氧饱和度（rSO₂）与重症颅脑损伤神经功能预后不良的关系及其预测神经功能预后的价值。方法 回顾性分析2018年1月—2019年6月医院收治的106例重症颅脑损伤术后患者和同时期本院收治的可疑脑损伤但是经检查健康的96例的资料，分别记为观察组和对照组。对观察组患者随访6个月依据格拉斯哥预后（GOS）评分进行重症颅脑损伤术后神经功能预后评价。对比观察组与对照组脑代谢指标（CERO₂、rSO₂）、观察组中预后良好者与预后不良者术后24 h CERO₂、rSO₂，分析术后24 h CERO₂、rSO₂与重症颅脑损伤术后神经功能预后不良的关系，分析术后24 h CERO₂、rSO₂与重症颅脑损伤术后神经功能预后不良的关系及预测价值。结果 观察组CERO₂、rSO₂均低于对照组（P<0.05）；重症颅脑损伤术后神经功能预后不良发生率为23.58%；观察组术后神经功能预后不良者术后24 h CERO₂、rSO₂均低于神经功能预后良好者（P<0.05）。多因素分析显示，年龄、合并基础疾病、开放性颅脑损伤、受伤至手术开始时间、术前格拉斯哥昏迷量表（GCS）评分中特重型、首次开颅手术时间、首次开颅手术中出血量、脑疝形成、颅内感染、康复治疗不依从、术后24 h CERO₂和术后24 h rSO₂均是重症颅脑损伤术后神经功能预后不良的影响因素（P<0.05）；术后24 h CERO₂、rSO₂联合预测重症颅脑损伤术后神经功能预后不良的灵敏度、曲线下面积（AUC）显著高于单独指标预测（P<0.05）。结论 重症颅脑损伤患者术后24 h CERO₂、rSO₂均偏低，且二者均是重症颅脑损伤术后神经功能预后不良的影响因素，联合预测神经功能预后不良的价值高。更多还原

【Abstract】 Objective To explore the relationship between cerebral extraction rate of oxygen （CERO₂）,regional saturation of oxygen （rSO₂） and poor prognosis of neurological function in severe head injury,and the value of predicting neurological prognosis.Methods A retrospective analysis of the data of 106 patients after operation with severe craniocerebral injury and 96 cases of suspected brain injury admitted to our hospital but checked healthy from January 2018 to June 2019 respectively recorded as the observation group and the control group.The patients in the observation group were followed up for 6 months,and the prognosis of neurological function was evaluated according to Glasgow Outcome Score （GOS）.The cerebral metabolic indexes （CERO₂,rSO₂） were compared between the observation group and the control group,and CERO₂and rSO₂at 24-hour after operation were compared between the patients with good prognoses and those with poor prognoses in the observation group,and analyze the relationship between CERO₂and rSO₂at 24-hour after severe craniocerebral injury operation and the poor prognoses of neurological function,and analyze the predictive value of the two indexes in the poor prognoses of neurological function after severe craniocerebral injury operation.Results The CERO₂and rSO₂in the observation group were lower than those in the control group （P<0.05）.The incidences of poor prognoses of neurological function after severe craniocerebral injury was 23.58%.The CERO₂and rSO₂at 24-hour after operation in the poor prognoses of neurological function were lower than those in the good prognoses of neurological function （P<0.05）.Age,combined basic diseases,open craniocerebral injury,the time from injury to the beginning of operation,the proportion of extra severe Glasgow Coma Scale （GCS）score before operation,operation time,blood loss during the first craniotomy,brain hernia formation,intracranial infection,non-compliance with rehabilitation treatment,CERO₂and rSO₂at 24-hour after operation were influence factors of neurological function poor prognoses after severe craniocerebral injury （P<0.05）.The sensitivity and area under curve （AUC） of CERO₂and rSO₂at 24-hour after operation combined predicted of the poor prognoses neurological function after severe craniocerebral injury operation were higher than those predicted by separate index（P<0.05）.Conclusion CERO₂and rSO₂are lower in patients with severe craniocerebral injury at 24-hour after operation,which are the influencing factors of neurological function poor prognoses of patients with severe craniocerebral injury,and the combination has high value of poor prognosis prediction of neurological function.更多还原