创伤性脑损伤术后血浆渗透压变化及其与icp cpp及预后相关性-changes of plasma osmotic pressure after traumatic brain injury and its correlation with icp cpp and prognosis.docxVIP

重庆医科重庆医科大学硕士研究生学位论文万方数据万方数据英汉缩略语名词对照英文缩写 英文全称 中文全称AANS ACTHamerican academy of neurological surgery adreno cortico tropic hormone美国神经外科学会促肾上腺皮质激素ADH antidiuretic hormone 抗利尿激素ALD aldosterone 醛固酮ARDS acute respiratory distress syndrome 急性呼吸窘迫综合征CBF cerebral blood flow 脑血流量CPP cerebral perfusion pressure 脑灌注压Glu ICPglutamate Intracranial pressure谷氨酸盐颅内压MBAP mean arterial blood pressure 平均动脉压MODSPtiO2multiple organ dysfunction syndromebrain tissue oxygen partial pressure多器官功能障碍综合症 脑组织氧分压STBI severe traumatic brain injury 重型颅脑创伤TBI traumatic brain injury 创伤性脑损伤1创伤性脑损伤术后血浆渗透压变化及其与ICP、CPP及预后相关性 摘要目的 动态测定创伤性脑损伤术后患者血浆渗透压变化，并探讨血 浆渗透压水平与颅内压（ICP）、脑灌注压（CPP）及预后之间的关系。 方法 回顾性分析重庆市急救中心神经外科从2012-05至2014-08入院后 行开颅手术的颅脑损伤患者59例，在术后1~5天测定血浆渗透压水平， 并结合ICP、CPP及患者预后进行分析。结果 术后血浆渗透压水平与 ICP呈负相关（P0.05），与CPP呈正相关（P0.05）。开颅术后预后不 良者的血浆渗透压水平明显高于预后良好者（P0.05）。结论 创伤性 脑损伤术后血浆渗透压水平的变化与生物物理学指标ICP、CPP间有内 在一致关系。监测创伤性脑损伤患者术后血浆渗透压水平联合ICP、CPP 指标，可对术后病情判断、预后评价提供依据并指导治疗。关键词：创伤性脑损伤，血浆渗透压，颅内压，脑灌注压，预后2DYNAMIC CHANGE IN SERUM LEVELS OF PLASMA OSMOTIC PRESSURE AND ITS RELATIONSHIP WITH THE PROGNOSIS IN PATIENTS ,ICP AND CPP IN PATIENTS AFTER CRANIOTOMY WITH TRAUMATIC BRAIN INJURYABSTRACTObjective To investigate the dynamic change of plasma osmotic pressure and its relationship with intracranial pressure(ICP), cerebral perfusion pressure(CPP) and the prognosis in the patients after craniotomy with traumatic brain injury(TBI). Methods A retrospective analysis was taken for 59 inpatients after craniotomy with TBI during May 2012 to August 2010. The plasma osmotic pressure ,ICP and CPP were determined 5 days after the craniotomy in all the patients. The relationship of plasma osmotic pressure with ICP, CPP and the prognosis was analyzed. Results Plasma osmotic pressure was negatively correlated with ICP (P0.05), and positively correlated with CPP (P0.05). The level of plasma osmotic pressure was significantly higher in the patients with poor prognosis than the patients with good. Conclusions There are inner relatio