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首页> 外文期刊>Acta neurochirurgica.Supplement >Cerebral perfusion pressure and spect in patients after craniocerebral injury with transtentorial herniation.
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Cerebral perfusion pressure and spect in patients after craniocerebral injury with transtentorial herniation.

机译：颅脑外伤合并经颅脑疝后患者的脑灌注压和斑点。

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摘要

We present a group of 29 consecutive head injured comatose patients with the syndrome of transtentorial herniation. All patients had urgent surgery and then continuous monitoring of ICP, CPP, blood pressure and jugular bulb oximetry was instituted. Two postoperative CT and SPECT examinations were performed in each patient. 15 patients had a normal CPP (> 70 mmHg) throughout the postoperative period, 80% of them had a favourable outcome. On the other hand 14 patients had decreased CPP lasting at least one hour and only 36% of them had a favourable outcome (p < 0.05). Similar relationships were found comparing GOS in patients with normal and increased ICP (> 20 mmHg) and normal and decreased SjO2 (< 55%). All but 3 patients had ischaemia on SPECT. Ischaemia improved on the 2nd SPECT in 11 patients and 10 (91%) of them had a favourable outcome. GOS (mean follow up 9 months) is: 12 patients good, 5 moderately disabled, 2 vegetative, 10 died. We conclude that SPECT is able to disclose even reversible ischaemic changes. In these patients all effort has to be made to keep CPP on normal levels. Improvement in cerebral perfusion is related to a better outcome.
机译：我们提出了一组29例连续性头部受伤的昏迷患者，并伴有经颅疝。所有患者均进行了紧急手术，然后建立了ICP，CPP，血压和颈静脉血氧饱和度的连续监测。每例患者均进行了两次术后CT和SPECT检查。 15位患者在整个术后CPP正常（> 70 mmHg），其中80％的结果良好。另一方面，有14例患者的CPP降低至少持续了一个小时，其中只有36％的患者预后良好（p <0.05）。比较ICP正常和升高（> 20 mmHg）和SjO2正常和降低（<55％）的患者中的GOS，发现了相似的关系。除3名患者外，所有患者均在SPECT上发生了局部缺血。在第2次SPECT上缺血改善了11例患者，其中10例（91％）的预后良好。 GOS（平均随访9个月）为：12例好，5例中度残疾，2例植物人，10例死亡。我们得出结论，SPECT能够揭示甚至可逆的缺血变化。在这些患者中，必须尽一切努力使CPP保持在正常水平。脑灌注的改善与更好的预后有关。

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