| Objective: To Monitor the change of jugular venous oxygen saturation after hypothermia therapy on patients with severe traumatic brain injury.Methods: Twenty-four cases sTBI patients (GCS≤8)were treated in the intensive care unit , Patients were randomly divided into NT group (n = 12) and HT group(n = 12)。In the NT group keep temperature at 36.5℃～37.5℃and in the HT group keep rectal temperature (RT) at 32.5℃to 35℃, monitoring of jugular venous oxygen saturation (SjO2) and cerebral arteriovenous oxygen difference (AVDO2) and intracranial ICP。Analysis the relationship with prognosis of mild hypothermia.Results: (1) Within 24 hours after injury the SjO2 in NT group were 36.32±11.45%, in HT Group were 44.06±19.53%, no significant difference between the two groups (P> 0.05).(2) SjO2 in NT group were 49.48±6.53% was significant difference with that before treatment (P <0.01). SjO2 in HT group were 59.63±13.85% after 48h treatment, was also significant difference with that before (P <0.05). (3) After 48 hours, SjO2 in HT group was significantly higher than it in the NT group (P < 0. 05). (4) After three months ,the outcome were evaluated by the GOS ,Outcome of HT group was better than it of NT group(P<0.05)。Conclusion : (1) The SjO2 of most sTBI patients was decreased and AVDO2 was increased after injury. SjO2 was increased 48 hours after injury and AVDO2 decline. SjO2 was important information of Brain anoxia , and reflects the transfer and cerebral oxygen metabolism in the brain。SjO2 levels significantly correlated with the outcome of patients. (2) The SjO2 was significantly increased in HT group(P <0.05). For the treatment of patients who have mild hypothermia may improve brain metabolism, prevent the secondary ischemic brain damage. (3) Monitoring Cerebral oxygen metabolism is simple, safe and reliable. Combinating AVDO2 and monitoring cerebral oxygen metabolism, it is an importent way to guiding treatment. |
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