{"id":48361,"date":"2025-03-03T05:10:53","date_gmt":"2025-03-03T05:10:53","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=48361"},"modified":"2025-03-03T05:10:53","modified_gmt":"2025-03-03T05:10:53","slug":"%e7%a5%9e%e7%bb%8f%e9%87%8d%e7%97%87%e7%9b%91%e6%8a%a4%e7%9a%84%e6%9c%aa%e6%9d%a5%ef%bc%9a-%e6%95%b4%e5%90%88%e7%a5%9e%e7%bb%8f%e7%89%a9%e7%90%86%e5%ad%a6%e3%80%81%e5%a4%9a%e6%a8%a1%e6%80%81%e7%9b%91","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=48361","title":{"rendered":"\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u7684\u672a\u6765\uff1a \u6574\u5408\u795e\u7ecf\u7269\u7406\u5b66\u3001\u591a\u6a21\u6001\u76d1\u6d4b\u548c\u673a\u5668\u5b66\u4e60"},"content":{"rendered":"

\u6574\u5408\u795e\u7ecf\u7269\u7406\u5b66\u3001\u591a\u6a21\u6001\u76d1\u6d4b\u548c\u673a\u5668\u5b66\u4e60<\/p>\n

\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u7684\u672a\u6765<\/p>\n

\u8fd1\u5e74\u6765\uff0c\u91cd\u75c7\u76d1\u62a4\u5ba4\uff08ICU\uff09\u4e2d\u7684\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u6280\u672f\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u6b65\uff0c\u5c24\u5176\u662f\u5728\u591a\u6a21\u6001\u76d1\u6d4b\uff08MMM\uff09\u9886\u57df\u3002\u8fd9\u4e9b\u8fdb\u6b65\u4ee5\u795e\u7ecf\u7269\u7406\u5b66\u539f\u7406\u4e3a\u57fa\u7840\uff0c\u6269\u5927\u4e86\u6211\u4eec\u5b9e\u65f6\u8bc4\u4f30\u5927\u8111\u529f\u80fd\u548c\u4ee3\u8c22\u72b6\u6001\u7684\u80fd\u529b\u3002\u5c3d\u7ba1\u73b0\u6709\u6280\u672f\u8d8a\u6765\u8d8a\u590d\u6742\u548c\u5148\u8fdb\uff0c\u4f46\u4e34\u5e8a\u533b\u751f\u5728\u9009\u62e9\u548c\u89e3\u91ca\u795e\u7ecf\u76d1\u6d4b\u6a21\u5f0f\u7684\u6700\u5408\u9002\u7ec4\u5408\u4ee5\u6539\u5584\u60a3\u8005\u9884\u540e\u65b9\u9762\u4ecd\u9762\u4e34\u76f8\u5f53\u5927\u7684\u6311\u6218\u3002<\/p>\n

      \u4f20\u7edf\u4e0a\uff0c\u91cd\u75c7\u76d1\u62a4\u5ba4\u7684\u795e\u7ecf\u76d1\u6d4b\u4e3b\u8981\u4f9d\u8d56\u4fb5\u5165\u6027\u6280\u672f\uff0c\u5982\u9885\u5185\u538b\uff08ICP\uff09\u76d1\u6d4b\u3001\u9888\u9759\u8109\u8840\u6c27\u9971\u548c\u5ea6\uff08SjvO2\uff09\u3001\u8111\u7ec4\u7ec7\u6c27\u76d1\u6d4b\u3001\u70ed\u6269\u6563\u8840\u6d41\u6d4b\u91cf\uff08TDF\uff09\u3001\u76ae\u5c42\u548c\u6df1\u5ea6\u8111\u7535\u56fe\uff08dEEG\uff09\u4ee5\u53ca\u8111\u5fae\u91cf\u900f\u6790\uff08CMD\uff09\u3002\u867d\u7136\u8fd9\u4e9b\u65b9\u6cd5\u53ef\u4ee5\u8fdb\u884c\u7cbe\u786e\u6d4b\u91cf\uff0c\u4f46\u4e5f\u5b58\u5728\u76f8\u5173\u98ce\u9669\uff0c\u5305\u62ec\u611f\u67d3\u548c\u51fa\u8840\u3002\u4e0d\u8fc7\uff0c\u6700\u8fd1\u795e\u7ecf\u76d1\u6d4b\u9886\u57df\u5df2\u5f00\u59cb\u5411\u65e0\u521b\u6a21\u5f0f\u8f6c\u53d8\u3002\u8fd9\u4e9b\u65b9\u6cd5\u5305\u62ec\u7ecf\u9885\u591a\u666e\u52d2\uff08TCD\uff09\u3001\u9f13\u819c\u79fb\u4f4d\uff08TMD\uff09\u3001\u8fd1\u7ea2\u5916\u5149\u8c31\uff08NIRS\uff09\u3001\u89c6\u795e\u7ecf\u9798\u76f4\u5f84\uff08ONSD\uff09\u3001\u6b63\u7535\u5b50\u53d1\u5c04\u65ad\u5c42\u626b\u63cf\uff08PET\uff09\u4ee5\u53ca\u901a\u8fc7\u5206\u6790\u5fc3\u7387\u53d8\u5f02\u6027\uff08HRV\uff09\u8fdb\u884c\u81ea\u4e3b\u795e\u7ecf\u8bc4\u4f30\u3002<\/p>\n

      \u5373\u4f7f\u53ef\u7528\u7684\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177\u8d8a\u6765\u8d8a\u591a\uff0c\u89e3\u8bfb\u6240\u751f\u6210\u6570\u636e\u7684\u590d\u6742\u6027\u4e5f\u5728\u589e\u52a0\u3002\u5728\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0c\u673a\u5668\u5b66\u4e60\u548c\u5176\u4ed6\u6570\u636e\u79d1\u5b66\u5de5\u5177\u5e94\u8fd0\u800c\u751f\uff0c\u6210\u4e3a\u4f20\u7edf\u65b9\u6cd5\u5927\u6709\u53ef\u4e3a\u7684\u8f85\u52a9\u5de5\u5177\u3002\u8fd9\u4e9b\u7b97\u6cd5\u53ef\u4ee5\u8fc7\u6ee4 MMM \u751f\u6210\u7684\u9ad8\u7ef4\u6570\u636e\uff0c\u4e3a\u4e34\u5e8a\u533b\u751f\u63d0\u4f9b\u60a3\u8005\u9884\u540e\u7684\u9884\u6d4b\u6a21\u578b\uff0c\u4ece\u800c\u4fc3\u8fdb\u4e2a\u4f53\u5316\u6cbb\u7597\u7b56\u7565\u7684\u5236\u5b9a\u3002<\/p>\n

       \u672c\u7efc\u8ff0\u65e8\u5728\u5bf9 MMM \u6280\u672f\u7684\u73b0\u72b6\u8fdb\u884c\u6279\u5224\u6027\u6982\u8ff0\uff0c\u91cd\u70b9\u5173\u6ce8 ICP\u3001\u8111\u7535\u6d3b\u52a8\u3001\u65b0\u9648\u4ee3\u8c22\/\u80fd\u91cf\u4ee3\u8c22\u548c\u81ea\u52a8\u8c03\u8282\u3002\u7814\u7a76\u4e86\u8fd9\u4e9b\u6280\u672f\u5728\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\u73af\u5883\u4e2d\u7684\u795e\u7ecf\u7269\u7406\u5b66\u57fa\u7840\u548c\u4e34\u5e8a\u610f\u4e49\u3002\u6b64\u5916\uff0c\u8fd8\u5c06\u901a\u8fc7\u63a2\u8ba8\u5982\u4f55\u5c06\u673a\u5668\u5b66\u4e60\u6574\u5408\u5230\u795e\u7ecf\u76d1\u6d4b\u5b9e\u8df5\u4e2d\uff0c\u4ee5\u534f\u52a9\u4e34\u5e8a\u533b\u751f\u53ca\u65f6\u51c6\u786e\u5730\u505a\u51fa\u4e2a\u6027\u5316\u60a3\u8005\u6cbb\u7597\u51b3\u7b56\uff0c\u4ece\u800c\u8ba8\u8bba\u673a\u5668\u5b66\u4e60\u7684\u65e5\u76ca\u5e7f\u6cdb\u5e94\u7528\u3002<\/p>\n

\u4e00<\/p>\n

\u8111\u810a\u6db2\u6d41\u4f53\u529b\u5b66<\/p>\n

\u4eba\u8111\u7684\u8ff7\u5bab\u7ed3\u6784\u4e0d\u4ec5\u53d7\u7ec6\u80de\u76f8\u4e92\u4f5c\u7528\u7684\u652f\u914d\uff0c\u8fd8\u53d7\u51b3\u5b9a\u6d41\u4f53\u52a8\u529b\u5b66\u3001\u538b\u529b\u68af\u5ea6\u548c\u65b0\u9648\u4ee3\u8c22\u4ea4\u6362\u7684\u7269\u7406\u539f\u7406\u7684\u652f\u914d\u3002\u5176\u4e2d\uff0c\u8111\u810a\u6db2\uff08CSF\uff09\u7684\u7269\u7406\u539f\u7406\u5728\u7ef4\u6301\u9885\u5185\u5e73\u8861\u65b9\u9762\u8d77\u7740\u6838\u5fc3\u4f5c\u7528\uff0c\u5e76\u4e0e\u6211\u4eec\u5728\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u5ba4\u4e2d\u8981\u76d1\u6d4b\u548c\u8c03\u8282\u7684\u53c2\u6570\u5bc6\u5207\u76f8\u5173\u3002\u4e86\u89e3 CSF \u7684\u7269\u7406\u7279\u6027\u5bf9\u89e3\u8bfb\u6709\u521b\u548c\u65e0\u521b\u795e\u7ecf\u76d1\u6d4b\u6570\u636e\u6709\u76f4\u63a5\u5f71\u54cd\uff0c\u6709\u52a9\u4e8e\u4f18\u5316\u60a3\u8005\u9884\u540e\u3002<\/p>\n

CSF \u662f\u5927\u8111\u7684\u6d6e\u529b\u57ab\uff0c\u6709\u52a9\u4e8e\u5e9f\u7269\u6392\u51fa\uff0c\u4e5f\u662f\u795e\u7ecf\u6d3b\u6027\u7269\u8d28\u5206\u5e03\u7684\u901a\u9053\u3002\u7136\u800c\uff0cCSF \u52a8\u529b\u5b66\u7684\u53d8\u5316\u4f1a\u5e26\u6765\u7834\u574f\u6027\u540e\u679c\uff0c\u8868\u73b0\u4e3a ICP \u5347\u9ad8\u3001\u5927\u8111\u81ea\u8c03\u8282\u529f\u80fd\u53d7\u635f\u548c\u4e0b\u6e38\u795e\u7ecf\u7cfb\u7edf\u6076\u5316\u3002\u56e0\u6b64\uff0c\u4e86\u89e3 CSF \u7684\u7269\u7406\u539f\u7406\u53ef\u4ee5\u66f4\u5168\u9762\u5730\u4e86\u89e3\u5927\u8111\u75c5\u7406\u751f\u7406\u5b66\uff0c\u5c24\u5176\u662f\u5728\u4e0e\u5176\u4ed6\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177\u76f8\u7ed3\u5408\u65f6\u3002\u672c\u8282\u5c06\u8ba8\u8bba\u652f\u914d CSF \u6d41\u91cf\u548c\u538b\u529b\u7684\u7269\u7406\u539f\u7406\uff0c\u5305\u62ec\u4f46\u4e0d\u9650\u4e8e\u6d41\u4f53\u9759\u529b\u5b66\u3001\u6d41\u4f53\u52a8\u529b\u5b66\u4ee5\u53ca CSF \u548c\u8111\u8840\u6d41\uff08CBF\uff09\u4e4b\u95f4\u7684\u8026\u8054\u3002<\/p>\n

\u8109\u7edc\u4e1b\u662f\u4f4d\u4e8e\u8111\u5ba4\u7cfb\u7edf\u5185\u7684\u4e00\u4e2a\u7531\u8840\u7ba1\u548c\u4e0a\u76ae\u7ec6\u80de\u7ec4\u6210\u7684\u7279\u6b8a\u7f51\u7edc\u3002\u5b83\u7684\u4e3b\u8981\u529f\u80fd\u662f\u4ea7\u751f\u8111\u810a\u6db2\u3002\u8fd9\u4e9b\u8840\u7ba1\u4e1b\u88ab\u4e00\u5c42\u4e0a\u76ae\u7ec6\u80de\u5305\u88f9\uff0c\u5728\u8840\u6db2\u548c\u8111\u810a\u6db2\u4e4b\u95f4\u8d77\u7740\u9009\u62e9\u6027\u6e17\u900f\u5c4f\u969c\u7684\u4f5c\u7528\u3002\u901a\u8fc7\u4e3b\u52a8\u5206\u6ccc\u3001\u8fc7\u6ee4\u548c\u91cd\u5438\u6536\u8fc7\u7a0b\u7684\u7ec4\u5408\uff0c\u8109\u7edc\u4e1b\u53ef\u4ee5\u4fdd\u6301 CSF \u7684\u6210\u5206\u548c\u5bb9\u91cf\uff0c\u8fd9\u5bf9\u7f13\u51b2\u5927\u8111\u3001\u63d0\u4f9b\u8425\u517b\u548c\u6e05\u9664\u5e9f\u7269\u81f3\u5173\u91cd\u8981\u3002\u8109\u7edc\u4e1b\u5b58\u5728\u4e8e\u5927\u8111\u7684\u6240\u6709\u56db\u4e2a\u8111\u5ba4\u4e2d\uff1a\u4e24\u4e2a\u4fa7\u8111\u5ba4\u3001\u7b2c\u4e09\u8111\u5ba4\u548c\u7b2c\u56db\u8111\u5ba4\u3002\u5927\u8111\u603b\u5bb9\u79ef\u4e3a 1400 \u6beb\u5347\uff0cCSF \u7ea6\u4e3a 150 \u6beb\u5347\u3002CSF \u7684\u751f\u6210\u901f\u5ea6\u7ea6\u4e3a 0.35 mL\/\u5206\u949f\uff08500 mL\/d\uff09\u3002<\/p>\n

\u8499\u7f57-\u51ef\u5229\u5b66\u8bf4\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u7684\u4e00\u4e2a\u57fa\u672c\u6982\u5ff5\uff0c\u5b83\u63cf\u8ff0\u4e86 ICP\u3001\u8111\u7ec4\u7ec7\u3001\u8840\u6db2\u548c CSF \u4e4b\u95f4\u7684\u5173\u7cfb\u3002\u6839\u636e\u8fd9\u4e00\u539f\u7406\uff0c\u9885\u9aa8\u662f\u4e00\u4e2a\u5305\u542b\u8fd9\u4e09\u4e2a\u90e8\u5206\u7684\u521a\u6027\u3001\u4e0d\u53ef\u6269\u5f20\u7684\u7ed3\u6784\u3002\u4efb\u4f55\u4e00\u79cd\u6210\u5206\u7684\u589e\u52a0\u90fd\u5fc5\u987b\u901a\u8fc7\u4e00\u79cd\u6216\u4e24\u79cd\u5269\u4f59\u6210\u5206\u7684\u51cf\u5c11\u6765\u8865\u507f\uff0c\u4ee5\u4fdd\u6301\u6052\u5b9a\u7684 ICP\u3002\u5982\u679c\u4e0d\u80fd\u8fbe\u5230\u8fd9\u79cd\u5e73\u8861\uff0c\u5c31\u4f1a\u5bfc\u81f4 ICP \u5347\u9ad8\uff0c\u4ece\u800c\u5bfc\u81f4\u795e\u7ecf\u529f\u80fd\u6076\u5316\u3002\u8170\u690e\u84c4\u6c34\u6c60\u662f\u8fd9\u4e00\u6846\u67b6\u4e2d\u7684\u91cd\u8981\u7f13\u51b2\u533a\u3002\u8fd9\u4e9b\u8d2e\u6c34\u6c60\u4f4d\u4e8e\u8170\u90e8\u86db\u7f51\u819c\u4e0b\u8154\uff0c\u662f CSF \u50a8\u5e93\uff0c\u53ef\u4ee5\u5bb9\u7eb3\u8fc7\u591a\u7684\u6db2\u4f53\u3002\u5f53\u8111\u6c34\u80bf\u3001\u8840\u80bf\u6216\u5176\u4ed6\u75c5\u53d8\u5bfc\u81f4 ICP \u589e\u9ad8\u65f6\uff0c\u8170\u690e\u8d2e\u6db2\u56ca\u53ef\u4ee5\u6269\u5f20\u4ee5\u63a5\u6536\u989d\u5916\u7684 CSF\uff0c\u4ece\u800c\u4f5c\u4e3a\u4e00\u79cd\u4ee3\u507f\u673a\u5236\u5e2e\u52a9\u7a33\u5b9a ICP\u3002\u5b83\u4eec\u4f5c\u4e3a \u201c\u5b89\u5168\u9600 \u201d\u7684\u4f5c\u7528\u51f8\u663e\u4e86\u9885\u5185\u8154\u5ba4\u5728\u8c03\u8282 ICP \u65b9\u9762\u7684\u590d\u6742\u6027\u548c\u9002\u5e94\u6027\uff0c\u5e76\u8fdb\u4e00\u6b65\u5f3a\u8c03\u4e86\u4e86\u89e3 CSF \u52a8\u6001\u5bf9\u6cbb\u7597\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u4e34\u5e8a\u91cd\u8981\u6027\u3002<\/p>\n

     CSF \u7684\u5f62\u6210\u7387\u7531\u4ee5\u4e0b\u516c\u5f0f\u786e\u5b9a\uff1aCSFprod = \u8f93\u6ce8\uff08Ci – Co\/Co\uff09\u3002\u5728\u8be5\u7b49\u5f0f\u4e2d\uff0c\u8f93\u6ce8\u662f\u4e00\u79cd\u7269\u8d28\uff08\u901a\u5e38\u662f\u793a\u8e2a\u5242\uff09\u8f93\u8fdb\u7cfb\u7edf\u7684\u901f\u5ea6\uff0cCi \u662f\u6d41\u5165\uff08\u901a\u5e38\u662f\u52a8\u8109\u8840\uff09\u4e2d\u8be5\u7269\u8d28\u7684\u6d53\u5ea6\uff0cCo \u662f\u6d41\u51fa\uff08\u901a\u5e38\u662f\u9759\u8109\u8840\u6216 CSF\uff09\u4e2d\u7684\u6d53\u5ea6\u3002\u8be5\u7b49\u5f0f\u8868\u660e\uff0cCSF \u7684\u751f\u6210\u901f\u5ea6\u53d7\u8f93\u6ce8\u901f\u5ea6\u4ee5\u53ca\u6d41\u5165\u548c\u6d41\u51fa\u6d53\u5ea6\u4e4b\u95f4\u68af\u5ea6\u7684\u5f71\u54cd\uff0c\u5e76\u4ee5\u6d41\u51fa\u6d53\u5ea6\u4e3a\u6807\u51c6\u3002\u8fd9\u79cd\u6570\u5b66\u8868\u793a\u6cd5\u63d0\u4f9b\u4e86\u4e00\u79cd\u91cf\u5316 CSF \u52a8\u6001\u7684\u65b9\u6cd5\uff0c\u5728\u9700\u8981\u7cbe\u786e\u6d4b\u91cf\u7684\u5b9e\u9a8c\u73af\u5883\u6216\u4e34\u5e8a\u8bc4\u4f30\u4e2d\u7279\u522b\u6709\u7528\u3002\u8fd9\u7a81\u51fa\u4e86\u7269\u8d28\u6d53\u5ea6\u4e0e\u8f93\u6ce8\u901f\u7387\u4e4b\u95f4\u7684\u76f8\u4e92\u4f5c\u7528\u5728\u51b3\u5b9a CSF \u5f62\u6210\u901f\u7387\u65b9\u9762\u7684\u91cd\u8981\u6027\uff0c\u4e3a\u4e86\u89e3\u8fd9\u4e00\u5173\u952e\u751f\u7406\u8fc7\u7a0b\u63d0\u4f9b\u4e86\u4e00\u4e2a\u5b9a\u91cf\u6846\u67b6\u3002<\/p>\n

\u745e\u5178\u7684 Ekstedt \u7b49\u4eba\u9996\u6b21\u4f7f\u7528\u6052\u538b\u8f93\u6ce8\u65b9\u6cd5\u66f4\u597d\u5730\u7814\u7a76\u4e86 CSF \u7684\u6d41\u4f53\u529b\u5b66\u3002\u4ed6\u4eec\u89c2\u5bdf\u5230 CSF \u538b\u529b-\u6d41\u91cf\u5448\u76f4\u7ebf\u5173\u7cfb\u3002\u56e0\u6b64\uff0c\u5f53 ICP \u5927\u4e8e\u77e2\u72b6\u7aa6\u538b\u529b\u65f6\uff0c\u901a\u8fc7\u77e2\u72b6\u7aa6\u7684\u6d41\u91cf\u589e\u52a0\u3002\u6b64\u5916\uff0c\u968f\u7740\u5e74\u9f84\u7684\u589e\u957f\uff0cCSF \u7684\u751f\u6210\u901f\u5ea6\u4e5f\u4e0d\u4f1a\u4fdd\u6301\u4e0d\u53d8\u3002\u5728\u8111\u79ef\u6c34\u60a3\u8005\u4e2d\uff0c\u5e74\u9f84\u7684\u589e\u957f\u4e0e CSF \u7684\u751f\u6210\u6210\u53cd\u6bd4\u3002\u52a8\u8109\u640f\u52a8\u5728\u8111\u5185 CSF \u7684\u52a8\u6001\u6d41\u52a8\u4e2d\u8d77\u7740\u81f3\u5173\u91cd\u8981\u7684\u4f5c\u7528\u3002\u5728\u6bcf\u4e2a\u5fc3\u52a8\u5468\u671f\u4e2d\uff0c\u52a8\u8109\u640f\u52a8\u90fd\u4f1a\u4ea7\u751f\u538b\u529b\u6ce2\uff0c\u8fd9\u4e9b\u538b\u529b\u6ce2\u5728\u5b9e\u8d28\u4e2d\u4f20\u64ad\u5e76\u5f71\u54cd CSF \u7684\u8fd0\u52a8\u3002\u8fd9\u4e9b\u640f\u52a8\u529b\u662f\u4e00\u79cd\u9a71\u52a8\u673a\u5236\uff0c\u6709\u52a9\u4e8e CSF \u901a\u8fc7\u8111\u5ba4\u7cfb\u7edf\u5faa\u73af\u5230\u5927\u8111\u548c\u810a\u9ad3\u5468\u56f4\u7684\u86db\u7f51\u819c\u4e0b\u8154\u3002\u52a8\u8109\u6709\u8282\u594f\u7684\u6269\u5f20\u548c\u6536\u7f29\u6709\u52a9\u4e8e CSF \u7684\u5f80\u8fd4\u8fd0\u52a8\uff0c\u4fc3\u8fdb CSF \u7684\u5206\u5e03\uff0c\u5e76\u6709\u52a9\u4e8e\u9885\u5185\u73af\u5883\u7684\u6574\u4f53\u5e73\u8861\u3002\u9ad8\u8840\u538b\u6216\u52a8\u8109\u50f5\u5316\u7b49\u60c5\u51b5\u4e0b\u51fa\u73b0\u7684\u52a8\u8109\u640f\u52a8\u7d0a\u4e71\u53ef\u80fd\u4f1a\u5f71\u54cd CSF \u7684\u52a8\u6001\u53d8\u5316\uff0c\u5e76\u53ef\u80fd\u4e0e\u5404\u79cd\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\u6709\u5173\u3002\u52a8\u8109\u4f4e\u8840\u538b\u6bcf\u964d\u4f4e 50 mmHg\uff0c\u8111\u810a\u6db2\u6d41\u51fa\u963b\u529b\u5c31\u4f1a\u964d\u4f4e\u7ea6 17%\u3002\u6b64\u5916\uff0c\u9ad8\u78b3\u9178\u8840\u75c7\u4f1a\u589e\u52a0\u8111\u810a\u6db2\u6d41\u51fa\u7684\u963b\u529b\uff08\u7ea6 18%\uff1b27-48 mmHg\uff09\u3002<\/p>\n

      \u8111\u90e8\u7684\u6dcb\u5df4\u5f15\u6d41\u7cfb\u7edf\u662f\u8fd1\u671f\u624d\u88ab\u53d1\u73b0\u7684\u5e9f\u7269\u6e05\u9664\u9014\u5f84\uff0c\u4e5f\u6d89\u53ca\u5bf9\u8111\u810a\u6db2\uff08CSF\uff09\u5438\u6536\u7684\u65b0\u7406\u89e3\u3002\u6839\u636e\u6dcb\u5df4\u5f15\u6d41\u7406\u8bba\uff0cCSF\u7ecf\u8fc7\u5305\u56f4\u52a8\u8109\u7684\u8840\u7ba1\u5468\u56f4\u7684\u5916\u8840\u7ba1\u95f4\u9699\u6d41\u52a8\uff0c\u8fdb\u5165\u8111\u5b9e\u8d28\uff0c\u5e76\u4e0e\u95f4\u8d28\u6db2\u6df7\u5408\u3002\u8fd9\u79cd\u6df7\u5408\u6709\u52a9\u4e8e\u53bb\u9664\u53ef\u6eb6\u6027\u86cb\u767d\u8d28\u548c\u4ee3\u8c22\u7269\uff0c\u5305\u62ec\u03b2\u6dc0\u7c89\u6837\u7269\u8d28\u7b49\u6709\u5bb3\u7269\u8d28\u3002\u7136\u540e\uff0c\u6db2\u4f53\u88ab\u5bfc\u5411\u9760\u8fd1\u9759\u8109\u7684\u95f4\u9759\u8109\u95f4\u9699\uff0c\u5e76\u6700\u7ec8\u6392\u5165\u6dcb\u5df4\u7cfb\u7edf\u3002\u636e\u4fe1\u6dcb\u5df4\u5f15\u6d41\u8fc7\u7a0b\u5728\u7761\u7720\u671f\u95f4\u66f4\u4e3a\u6d3b\u8dc3\uff0c\u5bf9\u7ef4\u6301\u8111\u5065\u5eb7\u81f3\u5173\u91cd\u8981\u3002\u8fd9\u4e00\u7406\u8bba\u4e3a\u4f20\u7edf\u6a21\u578b\u63d0\u4f9b\u4e86\u4e00\u79cd\u66ff\u4ee3\u6027\u6216\u8865\u5145\u6027\u89e3\u91ca\uff0c\u4f20\u7edf\u6a21\u578b\u4e3b\u8981\u5f3a\u8c03CSF\u4e3b\u8981\u901a\u8fc7\u7ed2\u6bdb\u548c\u86db\u7f51\u819c\u9897\u7c92\u8fdb\u884c\u6392\u6c34\u3002\u6dcb\u5df4\u5f15\u6d41\u7cfb\u7edf\u5728\u8111\u5b9e\u8d28\u5185\u90e8\u5438\u6536CSF\u7684\u4f5c\u7528\u4e3a\u4e86\u89e3\u548c\u6cbb\u7597\u4e0e\u5e9f\u7269\u79ef\u7d2f\u548c\u6db2\u4f53\u5e73\u8861\u6709\u5173\u7684\u795e\u7ecf\u75be\u75c5\u63d0\u4f9b\u4e86\u65b0\u9014\u5f84\u3002\u5c3d\u7ba1\u8fd1\u5e74\u6765\u5bf9\u8111\u819c\u6dcb\u5df4\u8840\u7ba1\u7684\u53d1\u73b0\u5f15\u8d77\u4e86\u8d8a\u6765\u8d8a\u591a\u7684\u5173\u6ce8\uff0c\u4f46\u4ecd\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u673a\u5236\u7814\u7a76\u6765\u9a8c\u8bc1\u6dcb\u5df4\u5f15\u6d41\u6a21\u578b\u4e2dCSF\u7684\u6d41\u4f53\u529b\u5b66\u3002<\/p>\n

\u4e8c<\/p>\n

CBF \u548c\u704c\u6ce8<\/p>\n

\u8111\u8840\u7ba1\u6811\u5177\u6709\u9519\u7efc\u590d\u6742\u7684\u591a\u5c42\u9762\u7ed3\u6784\uff0c\u80fd\u6709\u6548\u5730\u5411\u5927\u8111\u5404\u533a\u57df\u4f9b\u8840\u3002\u5a01\u5229\u65af\u73af\u6216\u591a\u8fb9\u5f62\u662f\u4f4d\u4e8e\u5927\u8111\u5e95\u90e8\u7684\u4e00\u4e2a\u91cd\u8981\u7684\u52a8\u8109\u591a\u8fb9\u5f62\uff0c\u662f\u8111\u90e8\u8840\u6db2\u5206\u5e03\u7684\u4e3b\u8981\u67a2\u7ebd\uff0c\u5b83\u8fde\u63a5\u7740\u524d\u90e8\u548c\u540e\u90e8\u7684\u8840\u6db2\u4f9b\u5e94\uff0c\u5e76\u63d0\u4f9b\u4fa7\u652f\u5faa\u73af\uff0c\u8fd9\u5728\u52a8\u8109\u95ed\u585e\u7684\u60c5\u51b5\u4e0b\u81f3\u5173\u91cd\u8981\u3002\u4ece\u5927\u52a8\u8109\u5206\u652f\u51fa\u6765\u7684\u5c0f\u52a8\u8109\u548c\u5c0f\u52a8\u8109\u7a7f\u900f\u8111\u5b9e\u8d28\uff0c\u5f62\u6210\u5e7f\u6cdb\u7684\u6bdb\u7ec6\u8840\u7ba1\u7f51\uff0c\u5e76\u5728\u6b64\u8fdb\u884c\u8425\u517b\u548c\u6c14\u4f53\u4ea4\u6362\u3002\u968f\u540e\uff0c\u8fd9\u4e9b\u6bdb\u7ec6\u8840\u7ba1\u6c47\u805a\u6210\u9759\u8109\u548c\u9759\u8109\uff0c\u6700\u7ec8\u5f62\u6210\u8f83\u5927\u7684\u9759\u8109\u7ed3\u6784\uff0c\u4fc3\u8fdb\u8131\u6c27\u8840\u6db2\u6392\u51fa\u5927\u8111\u3002<\/p>\n

\u5b89\u6770\u6d1b-\u83ab\u7d22\uff08Angelo Mosso\uff0c1846-1910 \u5e74\uff09\u662f 19 \u4e16\u7eaa\u672b\u610f\u5927\u5229\u6770\u51fa\u7684\u751f\u7406\u5b66\u5bb6\uff0c\u4ed6\u4e3a\u6211\u4eec\u4e86\u89e3 CBF \u548c\u65b0\u9648\u4ee3\u8c22\u505a\u51fa\u4e86\u91cd\u5927\u8d21\u732e\u3002\u83ab\u7d22\u662f\u63a2\u7d22\u5927\u8111\u8840\u6db2\u5faa\u73af\u52a8\u529b\u5b66\u7684\u5148\u9a71\u4e4b\u4e00\uff0c\u4e3a\u73b0\u4ee3\u795e\u7ecf\u751f\u7406\u5b66\u7814\u7a76\u5960\u5b9a\u4e86\u57fa\u7840\u3002\u4ed6\u5de7\u5999\u5730\u8bbe\u8ba1\u4e86\u795e\u7ecf\u5916\u79d1\u9885\u9aa8\u7f3a\u635f\u60a3\u8005\u7684\u5b9e\u9a8c\uff0c\u5e76\u5f00\u53d1\u4e86\u65e9\u671f\u7684\u4eea\u5668\u6765\u7814\u7a76\u4e0d\u540c\u751f\u7406\u548c\u5fc3\u7406\u523a\u6fc0\u4e0b\u8111\u8840\u5bb9\u91cf\u548c\u538b\u529b\u7684\u53d8\u5316\u3002\u83ab\u7d22\u53d1\u660e\u4e86 \u201c\u4eba\u4f53\u5faa\u73af\u5e73\u8861\u201d\uff0c\u8fd9\u662f\u4e00\u79cd\u65e0\u521b\u7684 CBF \u6d4b\u91cf\u65b9\u6cd5\uff0c\u8bc1\u660e\u60c5\u7eea\u538b\u529b\u548c\u667a\u529b\u6d3b\u52a8\u4e0e\u8111\u52a8\u8109\u640f\u52a8\u589e\u52a0\u6709\u5173\u3002\u83ab\u7d22\u7684\u7ec6\u81f4\u7814\u7a76\u8bc1\u660e\u4e86\u5927\u8111\u6d3b\u52a8\u4e0e\u8840\u6d41\u53d8\u5316\u4e4b\u95f4\u7684\u5173\u7cfb\uff0c\u63d0\u51fa\u4e86\u795e\u7ecf\u8840\u7ba1\u8026\u5408\u7684\u6982\u5ff5\u3002\u8111\u8840\u7ba1\u5185\u7684\u8840\u6d41\u53d7\u6d41\u4f53\u52a8\u529b\u5b66\u539f\u7406\u652f\u914d\u3002\u6839\u636e Poiseuille \u5b9a\u5f8b\uff0c\u901a\u8fc7\u5706\u67f1\u7ba1\u7684\u6d41\u91cf\uff08Q\uff09\u4e0e\u534a\u5f84\uff08r\uff09\u548c\u538b\u529b\u68af\u5ea6\uff08\u0394P\uff09\u7684\u56db\u6b21\u65b9\u6210\u6b63\u6bd4\uff0c\u4e0e\u6d41\u4f53\u7684\u957f\u5ea6\uff08L\uff09\u548c\u7c98\u5ea6\uff08\u03b7\uff09\u6210\u53cd\u6bd4\u3002\u6570\u5b66\u4e0a\u53ef\u8868\u793a\u4e3a Q = (\u03c0r4 \u0394P)\/8\u03b7L<\/p>\n

\u8fd9\u4e00\u65b9\u7a0b\u5f0f\u8bf4\u660e\u4e86\u8840\u7ba1\u534a\u5f84\u7684\u5fae\u5c0f\u53d8\u5316\u5982\u4f55\u5bf9\u8840\u6d41\u4ea7\u751f\u6df1\u8fdc\u5f71\u54cd\uff0c\u5f3a\u8c03\u4e86\u8840\u7ba1\u5f20\u529b\u8c03\u8282\u5bf9\u7ef4\u6301\u5145\u8db3\u8111\u704c\u6ce8\u7684\u91cd\u8981\u6027\u3002\u6b64\u5916\uff0c\u96f7\u8bfa\u6570\u53ef\u4ee5\u91cf\u5316\u8840\u7ba1\u5185\u5c42\u6d41\u4e0e\u6e4d\u6d41\u7684\u53ef\u80fd\u6027\uff0c\u662f\u4e86\u89e3\u8111\u8840\u7ba1\u6d41\u52a8\u7279\u6027\u7684\u5173\u952e\u3002\u5927\u8111\u7684\u81ea\u52a8\u8c03\u8282\u673a\u5236\u901a\u8fc7\u52a8\u8109\u8840\u7ba1\u7684\u8840\u7ba1\u6269\u5f20\u548c\u8840\u7ba1\u6536\u7f29\u6765\u8c03\u8282\u8840\u7ba1\u963b\u529b\uff0c\u4ece\u800c\u5728\u5168\u8eab\u8840\u538b\u6ce2\u52a8\u7684\u60c5\u51b5\u4e0b\u4ecd\u80fd\u786e\u4fdd\u6052\u5b9a\u7684\u8840\u6d41\u91cf\u3002\u8fd9\u4e9b\u673a\u5236\u7684\u4efb\u4f55\u7834\u574f\u90fd\u4f1a\u5bfc\u81f4\u75c5\u7406\u72b6\u6001\uff0c\u5982\u5145\u8840\u6216\u7f3a\u8840\uff0c\u4ece\u800c\u635f\u5bb3\u8111\u7ec4\u7ec7\u7684\u5b8c\u6574\u6027\u53ca\u5176\u529f\u80fd\u3002\u5728\u9759\u606f\u6e05\u9192\u72b6\u6001\u4e0b\uff0c\u4eba\u8111\u6d88\u8017\u6c27\u6c14\u7684\u901f\u5ea6\u4e3a 35mL\/min\/kg\u3002\u8fd9\u53ef\u4ee5\u901a\u8fc7\u4ee5\u4e0b\u7b49\u5f0f\u8fdb\u884c\u6570\u5b66\u8ba1\u7b97\uff1a\u8111\u6c27\u4ee3\u8c22\u7387 = CBF \u00d7 \u52a8\u9759\u8109\u6c27\u5dee\u3002<\/p>\n

\u4e09<\/p>\n

CBF\u81ea\u52a8\u8c03\u8282<\/p>\n

\u4e39\u9ea6\u79d1\u5b66\u5bb6\u548c\u6559\u6388\u83ab\u6839\u65af-\u798f\u683c\uff08Mogens Fog\uff0c1904-1990 \u5e74\uff09\u4e8e 1938 \u5e74\u76f4\u63a5\u7814\u7a76\u4e86\u732b\u7684\u76ae\u5c42\u8840\u7ba1\u53ca\u5176\u5bf9\u5404\u79cd\u523a\u6fc0\u7684\u53cd\u5e94\u3002\u4ed6\u89c2\u5bdf\u5230\uff0c\u8840\u538b\u964d\u4f4e\u4f1a\u7acb\u5373\u5bfc\u81f4\u8840\u7ba1\u6536\u7f29\uff0c\u7ee7\u800c\u6269\u5f20\u76ae\u8d28\u8840\u7ba1\uff1b\u8840\u538b\u5347\u9ad8\u4f1a\u7acb\u5373\u5bfc\u81f4\u8840\u7ba1\u6269\u5f20\uff0c\u7ee7\u800c\u6536\u7f29\u8840\u7ba1\u30021959 \u5e74\uff0c\u62c9\u68ee\u7ed8\u5236\u4e86\u8457\u540d\u7684\u5927\u8111\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\uff0c\u5e76\u6784\u60f3\u51fa\u4e86\u4e00\u4e2a\u8f83\u5bbd\u7684\u5e73\u5747\u52a8\u8109\u538b (MAP) \u8303\u56f4\uff08\u7ea6 60-150 mmHg\uff09\uff0c\u5728\u6b64\u8303\u56f4\u5185 CBF \u4fdd\u6301\u4e0d\u53d8\u3002Lassen \u7684\u5927\u8111\u81ea\u52a8\u8c03\u8282\u56fe\u89e3\u7ee7\u7eed\u5728\u5f71\u54cd\u529b\u8f83\u5927\u7684\u7814\u7a76\u6587\u7ae0\u548c\u6559\u79d1\u4e66\u4e2d\u6d41\u884c\uff08\u56fe 1\uff09\u3002<\/p>\n

\u56fe 1 \u62c9\u68ee\u5927\u8111\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\u3002\u636e\u62a5\u9053\uff0c\u8111\u8840\u6d41\u91cf\u901a\u5e38\u5728 50-150 mmHg \u7684\u8f83\u5927\u5e73\u5747\u52a8\u8109\u538b\u8303\u56f4\u5185\u4fdd\u6301\u6052\u5b9a\u3002\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u7684\u8fd9\u4e00\u8303\u56f4\u4f1a\u660e\u663e\u504f\u79fb\u6216\u7f29\u5c0f\u3002\u7f3a\u8840\u4e34\u754c\u704c\u6ce8\u9608\u503c\u5b9a\u4e49\u4e3a 30 \u6beb\u5347\/100 \u514b\/\u5206\u949f\u3002<\/p>\n

\u7136\u800c\uff0c\u62c9\u68ee\u7684\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\u7531\u4e8e\u5176\u4e0d\u51c6\u786e\u6027\u548c\u4e2a\u4f53\u95f4\u7684\u5f02\u8d28\u6027\uff0c\u6700\u8fd1\u53d7\u5230\u4e86\u4e25\u683c\u7684\u5ba1\u67e5\u3002\u6b64\u5916\uff0c\u62c9\u68ee\u5173\u4e8e\u5927\u8111\u81ea\u52a8\u8c03\u8282\u7684\u539f\u59cb\u7814\u7a76\u56e0\u6837\u672c\u91cf\u5c0f\u3001\u5355\u6570\u636e\u70b9\u5206\u6790\u548c\u8bef\u5dee\u8303\u56f4\u62a5\u544a\u4e0d\u8db3\u800c\u53d7\u5230\u6279\u8bc4\u3002\u7136\u800c\uff0c\u62c9\u68ee\u7684\u5f00\u521b\u6027\u5de5\u4f5c\u4e3a\u7406\u89e3\u5927\u8111\u81ea\u52a8\u8c03\u8282\u63d0\u4f9b\u4e86\u4e00\u4e2a\u57fa\u7840\u6846\u67b6\u3002Czosnyka \u7b49\u4eba\u901a\u8fc7\u5bf9\u8111\u5916\u4f24\uff08TBI\uff09\u60a3\u8005\u7684 CBF \u8fdb\u884c\u6bcf\u65e5 TCD \u5206\u6790\uff0c\u8bc1\u660e\u4e86\u8fd9\u79cd\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\u3002\u4ed6\u4eec\u8bc1\u660e\u4e86\u81ea\u52a8\u8c03\u8282\u7684\u4e0b\u9650\u548c\u4e0a\u9650\uff0c\u4ee5\u53ca Lassen \u6700\u521d\u8bc1\u660e\u7684\u9ad8\u539f\u3002\u7136\u800c\uff0c\u4e0e Lassen \u58f0\u79f0\u7684\u5bbd\u8303\u56f4\u76f8\u53cd\uff0c\u8fd9\u91cc\u5b9e\u9a8c\u663e\u793a\u7684\u66f2\u7ebf\u53ea\u6709\u5927\u7ea6 40 mmHg\u3002\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\u4e2d\u8fd9\u4e00\u76f8\u5bf9\u8f83\u5c0f\u7684\u5e73\u53f0\uff0c\u636e\u4fe1\u662f\u7531\u4e8e\u8fd9\u4e9b\u60a3\u8005\u906d\u53d7\u4e86\u6025\u6027\u8111\u635f\u4f24\u6240\u81f4\u3002<\/p>\n

\u5927\u8111\u81ea\u52a8\u8c03\u8282\u7684\u57fa\u672c\u539f\u7406\u662f\uff0c\u5c3d\u7ba1\u5168\u8eab\u8840\u538b\u51fa\u73b0\u6ce2\u52a8\uff0c\u4f46 CBF \u4ecd\u80fd\u4fdd\u6301\u6052\u5b9a\uff0c\u4ece\u800c\u786e\u4fdd\u5fae\u5999\u800c\u590d\u6742\u7684\u795e\u7ecf\u7f51\u7edc\u83b7\u5f97\u6301\u7eed\u7684\u8425\u517b\u548c\u6c27\u4f9b\u5e94\u3002\u8fd9\u4e00\u9519\u7efc\u590d\u6742\u7684\u673a\u5236\u662f\u7531\u808c\u6e90\u6027\u3001\u5316\u5b66\u6027\u3001\u795e\u7ecf\u5143\u548c\u65b0\u9648\u4ee3\u8c22\u53cd\u5e94\u7684\u4ea4\u54cd\u4e50\u7f16\u6392\u800c\u6210\u7684\uff0c\u8fd9\u4e9b\u53cd\u5e94\u52a8\u6001\u5730\u5141\u8bb8\u8111\u52a8\u8109\u8840\u7ba1\u6269\u5f20\u548c\u6536\u7f29\u3002Kontos \u7b49\u4eba\u8bc1\u5b9e\u4e86\u8111\u8840\u7ba1\u6269\u5f20\u548c\u6536\u7f29\u5bf9\u5168\u8eab\u8840\u538b\u6ce2\u52a8\u7684\u53cd\u5e94\u3002\u6709\u8da3\u7684\u662f\uff0c\u523a\u6fc0\u8ff7\u8d70\u795e\u7ecf\u53ef\u4f7f\u538b\u529b\u611f\u53d7\u5668\u4f20\u51fa\u6d3b\u52a8\u589e\u52a0\uff0c\u968f\u540e MAP \u4e0b\u964d\uff0c\u800c\u76f8\u5e94\u7684\u6861\u52a8\u8109\u8840\u7ba1\u76f4\u5f84\u7684\u589e\u52a0\u5219\u4f1a\u51fa\u73b0\u7ea6 10 \u79d2\u949f\u7684\u76f8\u79fb\u3002\u5728\u968f\u540e\u7684\u5b9e\u9a8c\u4e2d\uff0c\u8fde\u7eed\u8f93\u6ce8 ATP \u4f1a\u5bfc\u81f4\u5168\u8eab\u6027\u4f4e\u8840\u538b\u7684\u632f\u8361\u53d1\u4f5c\uff0c\u540c\u65f6\u6861\u52a8\u8109\u76f4\u5f84\u4e5f\u4f1a\u51fa\u73b0\u76f8\u5e94\u7684\u632f\u8361\u4f46\u76f8\u79fb\u7684\u53cd\u5e94\u3002<\/p>\n

MAP \u662f\u60a3\u8005\u5728\u4e00\u4e2a\u5fc3\u52a8\u5468\u671f\u5185\u52a8\u8109\u4e2d\u7684\u5e73\u5747\u538b\u529b\u3002\u5b83\u662f\u5fc3\u8f93\u51fa\u91cf\uff08CO\uff09\u548c\u5168\u8eab\u8840\u7ba1\u963b\u529b\uff08SVR\uff09\u7684\u51fd\u6570\uff1aMAP = CO \u00d7 SVR + \u4e2d\u5fc3\u9759\u8109\u538b\u3002\u4e0d\u8fc7\uff0c\u7531\u4e8e\u4e2d\u5fc3\u9759\u8109\u538b\u901a\u5e38\u6bd4 MAP \u4f4e\u5f97\u591a\uff08\u5065\u5eb7\u4eba\u7684\u4e2d\u5fc3\u9759\u8109\u538b\u901a\u5e38\u63a5\u8fd1\u4e8e\u96f6\uff09\uff0c\u56e0\u6b64\u5728\u8ba1\u7b97\u4e2d\u901a\u5e38\u4f1a\u7701\u7565\u4e2d\u5fc3\u9759\u8109\u538b\uff0c\u5c06\u5176\u7b80\u5316\u4e3a\uff1aMAP = CO \u00d7 SVR\u3002\u901a\u5e38\u4e5f\u4f7f\u7528\u6536\u7f29\u538b\u548c\u8212\u5f20\u538b (DBP) \u4f30\u7b97 MAP\uff1aMAP \u2248 DBP + 1\/3\uff08\u6536\u7f29\u538b – DBP\uff09\u3002<\/p>\n

ICP \u662f\u9885\u5185\u6db2\u4f53\uff08\u5982 CSF\uff09\u548c\u7ec4\u7ec7\u65bd\u52a0\u7684\u538b\u529b\u3002ICP \u5347\u9ad8\u4f1a\u964d\u4f4e CBF\u3002\u8111\u704c\u6ce8\u538b (CPP) \u662f\u5c06\u6c27\u548c\u8425\u517b\u7269\u8d28\u8f93\u9001\u5230\u8111\u7ec4\u7ec7\u7684\u51c0\u538b\u529b\u68af\u5ea6\u3002\u5b83\u662f\u786e\u4fdd\u8840\u6db2\u6d41\u7ecf\u8111\u8840\u7ba1\u7684\u53ef\u7528\u538b\u529b\u3002\u7531\u4e8e\u8840\u6db2\u5fc5\u987b\u4ece\u5168\u8eab\u5faa\u73af\uff08\u4ee5 MAP \u8868\u793a\uff09\u6d41\u5165\u9885\u5185\u7a7a\u95f4\uff08\u5176\u538b\u529b\u4e3a ICP\uff09\uff0c\u56e0\u6b64\u9a71\u52a8\u8fd9\u79cd\u6d41\u52a8\u7684\u6709\u6548\u538b\u529b\uff08CPP\uff09\u5c31\u662f\u8fd9\u4e24\u4e2a\u538b\u529b\u4e4b\u5dee\uff1aCPP = MAP – ICP\u3002<\/p>\n

\u808c\u6e90\u6027\/\u5185\u76ae\u53cd\u5e94<\/p>\n

\u4e39\u9ea6\u79d1\u5b66\u5bb6\u548c\u6559\u6388\u83ab\u6839\u65af-\u798f\u683c\uff08Mogens Fog\uff0c1904-1990 \u5e74\uff09\u4e8e 1938 \u5e74\u76f4\u63a5\u7814\u7a76\u4e86\u732b\u7684\u76ae\u5c42\u8840\u7ba1\u53ca\u5176\u5bf9\u5404\u79cd\u523a\u6fc0\u7684\u53cd\u5e94\u3002\u4ed6\u89c2\u5bdf\u5230\uff0c\u8840\u538b\u964d\u4f4e\u4f1a\u7acb\u5373\u5bfc\u81f4\u8840\u7ba1\u6536\u7f29\uff0c\u7ee7\u800c\u6269\u5f20\u76ae\u8d28\u8840\u7ba1\uff1b\u8840\u538b\u5347\u808c\u6e90\u6027\u53cd\u5e94\u662f\u81ea\u52a8\u8c03\u8282\u7684\u57fa\u672c\u7ec4\u6210\u90e8\u5206\uff0c\u52a8\u8109\u8840\u7ba1\u4e2d\u7684\u8840\u7ba1\u5e73\u6ed1\u808c\u7ec6\u80de\u4f1a\u5bf9\u8840\u7ba1\u5185\u538b\u529b\u7684\u53d8\u5316\u505a\u51fa\u53cd\u5e94\u3002\u538b\u529b\u5347\u9ad8\u4f1a\u5f15\u8d77\u8840\u7ba1\u6536\u7f29\uff0c\u51cf\u5c11\u8840\u6d41\u91cf\uff0c\u800c\u538b\u529b\u964d\u4f4e\u5219\u4f1a\u5f15\u53d1\u8840\u7ba1\u6269\u5f20\uff0c\u589e\u52a0\u8840\u6d41\u91cf\u3002\u8fd9\u4e00\u56fa\u6709\u673a\u5236\u5bf9\u9632\u6b62\u5927\u8111\u8fc7\u5ea6\u704c\u6ce8\u6216\u704c\u6ce8\u4e0d\u8db3\u81f3\u5173\u91cd\u8981\uff0c\u4ece\u800c\u4fdd\u969c\u4e86\u795e\u7ecf\u7684\u5b8c\u6574\u6027\u3002\u4e00\u6c27\u5316\u6c2e\uff08NO\uff09\u3001\u5185\u76ae\u6e90\u6027\u8d85\u6781\u5316\u56e0\u5b50\u548c\u524d\u5217\u73af\u7d20\u662f\u5185\u76ae\u56e0\u5b50\u548c\u5f3a\u6548\u8840\u7ba1\u6269\u5f20\u5242\u3002\u5185\u76ae\u7d20 1\u3001\u8840\u6813\u7d20 A2 \u548c\u8840\u7ba1\u7d27\u5f20\u7d20 II \u662f\u4f7f\u52a8\u8109\u8840\u7ba1\u6536\u7f29\u7684\u5185\u76ae\u56e0\u5b50\u3002NO \u7531\u5185\u76ae NO \u5408\u9176\u5408\u6210\u3002NO \u6269\u6563\u5230\u8840\u7ba1\u58c1\u7684\u5e73\u6ed1\u808c\u7ec6\u80de\uff0c\u6fc0\u6d3b\u9e1f\u82f7\u9178\u73af\u5316\u9176\uff0c\u5bfc\u81f4\u5355\u78f7\u9178\u73af\u9e1f\u82f7\u589e\u52a0\u548c\u8840\u7ba1\u6269\u5f20\uff0c\u4ece\u800c\u8c03\u8282 CBF\u3002\u524d\u5217\u73af\u7d20\u662f\u7531\u5185\u76ae\u7ec6\u80de\u5408\u6210\u7684\u53e6\u4e00\u79cd\u91cd\u8981\u7684\u8840\u7ba1\u6269\u5f20\u5242\u3002\u5b83\u80fd\u6fc0\u6d3b\u5e73\u6ed1\u808c\u7ec6\u80de\u4e2d\u7684\u817a\u82f7\u9178\u73af\u5316\u9176\uff0c\u5bfc\u81f4\u73af\u78f7\u9178\u817a\u82f7\u6c34\u5e73\u5347\u9ad8\uff0c\u8fdb\u800c\u4f7f\u8840\u7ba1\u5e73\u6ed1\u808c\u677e\u5f1b\u3002\u5185\u76ae\u6e90\u6027\u8d85\u6781\u5316\u56e0\u5b50\u53ef\u4f7f\u8840\u7ba1\u5e73\u6ed1\u808c\u7ec6\u80de\u8d85\u6781\u5316\uff0c\u4ece\u800c\u5bfc\u81f4\u8840\u7ba1\u677e\u5f1b\u548c\u6269\u5f20\uff0c\u4f46\u5176\u786e\u5207\u8eab\u4efd\u548c\u4f5c\u7528\u673a\u5236\u4ecd\u5728\u7814\u7a76\u4e4b\u4e2d\u3002\u5185\u76ae\u7d20 1 \u662f\u4e00\u79cd\u7531\u5185\u76ae\u7ec6\u80de\u4ea7\u751f\u7684\u5f3a\u6548\u8840\u7ba1\u6536\u7f29\u5242\u3002\u5b83\u4e3b\u8981\u901a\u8fc7\u8840\u7ba1\u5e73\u6ed1\u808c\u7ec6\u80de\u4e0a\u7684 ET-A \u53d7\u4f53\u53d1\u6325\u4f5c\u7528\uff0c\u5bfc\u81f4\u7ec6\u80de\u5185\u9499\u589e\u52a0\u548c\u5e73\u6ed1\u808c\u6536\u7f29\u3002\u5185\u76ae\u7ec6\u80de\u5408\u6210\u7684\u8840\u6813\u7d20 A2 \u901a\u8fc7\u4fc3\u8fdb\u8840\u7ba1\u5e73\u6ed1\u808c\u7ec6\u80de\u5185\u9499\u7684\u52a8\u5458\uff0c\u8d77\u5230\u6536\u7f29\u8840\u7ba1\u7684\u4f5c\u7528\u3002\u901a\u8fc7\u80be\u7d20-\u8840\u7ba1\u7d27\u5f20\u7d20\u7cfb\u7edf\u4ea7\u751f\u7684\u8840\u7ba1\u7d27\u5f20\u7d20 II \u53ef\u6fc0\u6d3b\u8840\u7ba1\u5e73\u6ed1\u808c\u7ec6\u80de\u4e2d\u7684\u8840\u7ba1\u7d27\u5f20\u7d20 I \u53d7\u4f53\uff0c\u4ece\u800c\u8bf1\u5bfc\u8840\u7ba1\u6536\u7f29\u3002\u8840\u7ba1\u6269\u5f20\u5242\u548c\u8840\u7ba1\u6536\u7f29\u5242\u6839\u636e\u8de8\u58c1\u538b\u529b\u7684\u53d8\u5316\u534f\u8c03\u4f5c\u7528\uff0c\u786e\u4fdd CBF \u7ef4\u6301\u5728\u4e00\u5b9a\u7684\u704c\u6ce8\u538b\u529b\u8303\u56f4\u5185\uff0c\u4fdd\u62a4\u5927\u8111\u514d\u53d7\u4f4e\u704c\u6ce8\u548c\u9ad8\u704c\u6ce8\u4e8b\u4ef6\u7684\u5f71\u54cd\u3002\u6b64\u5916\uff0c\u9541\u53ef\u80fd\u5728\u7ef4\u6301\u8111\u8840\u7ba1\u5185\u76ae\u5e73\u8861\u65b9\u9762\u53d1\u6325\u91cd\u8981\u4f5c\u7528\uff0c\u5e76\u4e0e\u53ef\u9006\u6027\u8111\u8840\u7ba1\u6536\u7f29\u7efc\u5408\u5f81\u548c\u540e\u53ef\u9006\u6027\u8111\u75c5\u7efc\u5408\u5f81\u7b49\u8111\u52a8\u8109\u75be\u75c5\u6709\u5173\u3002\u9ad8\u4f1a\u7acb\u5373\u5bfc\u81f4\u8840\u7ba1\u6269\u5f20\uff0c\u7ee7\u800c\u6536\u7f29\u8840\u7ba1\u30021959 \u5e74\uff0c\u62c9\u68ee\u7ed8\u5236\u4e86\u8457\u540d\u7684\u5927\u8111\u81ea\u52a8\u8c03\u8282\u66f2\u7ebf\uff0c\u5e76\u6784\u60f3\u51fa\u4e86\u4e00\u4e2a\u8f83\u5bbd\u7684\u5e73\u5747\u52a8\u8109\u538b (MAP) \u8303\u56f4\uff08\u7ea6 60-150 mmHg\uff09\uff0c\u5728\u6b64\u8303\u56f4\u5185 CBF \u4fdd\u6301\u4e0d\u53d8\u3002Lassen \u7684\u5927\u8111\u81ea\u52a8\u8c03\u8282\u56fe\u89e3\u7ee7\u7eed\u5728\u5f71\u54cd\u529b\u8f83\u5927\u7684\u7814\u7a76\u6587\u7ae0\u548c\u6559\u79d1\u4e66\u4e2d\u6d41\u884c\uff08\u56fe 1\uff09\u3002<\/p>\n

\u5316\u5b66\/\u4ee3\u8c22\u53cd\u5e94<\/p>\n

\u5316\u5b66\u8c03\u8282\u662f\u53e6\u4e00\u4e2a\u91cd\u8981\u65b9\u9762\uff0c\u4e3b\u8981\u7531\u8111\u8840\u7ba1\u5e73\u6ed1\u808c\u5185\u4e8c\u6c27\u5316\u78b3\u3001\u6c22\u79bb\u5b50\u548c\u6c27\u6c14\u6d53\u5ea6\u7684\u53d8\u5316\u9a71\u52a8\u3002\u4e8c\u6c27\u5316\u78b3\u5bf9\u8111\u8840\u7ba1\u6709\u6df1\u8fdc\u7684\u6269\u5f20\u4f5c\u7528\u3002\u8840\u6db2\u4e2d\u4e8c\u6c27\u5316\u78b3\u6d53\u5ea6\u5347\u9ad8\u6216\u9ad8\u78b3\u9178\u8840\u75c7\u4f1a\u5bfc\u81f4\u8840\u6db2 pH \u503c\u964d\u4f4e\uff08\u547c\u5438\u6027\u9178\u4e2d\u6bd2\uff09\uff0c\u4fc3\u4f7f\u8111\u52a8\u8109\u8840\u7ba1\u6269\u5f20\uff0c\u8fdb\u800c\u589e\u52a0 CBF \u4ee5\u6ee1\u8db3\u589e\u52a0\u7684\u4ee3\u8c22\u9700\u6c42\u3002\u8fd9\u79cd\u673a\u5236\u5728\u5927\u8111\u6d3b\u52a8\u589e\u52a0\u6216\u547c\u5438\u72b6\u6001\u6539\u53d8\u65f6\u5c24\u4e3a\u91cd\u8981\uff0c\u56e0\u4e3a\u4e8c\u6c27\u5316\u78b3\u751f\u6210\u6216\u6f74\u7559\u7684\u589e\u52a0\u9700\u8981\u589e\u52a0\u5927\u8111\u7684\u8840\u6db2\u4f9b\u5e94\u3002\u76f8\u53cd\uff0c\u4e8c\u6c27\u5316\u78b3\u6c34\u5e73\u964d\u4f4e\u6216\u4f4e\u78b3\u9178\u8840\u75c7\u4f1a\u5f15\u8d77\u8111\u8840\u7ba1\u6536\u7f29\uff0c\u964d\u4f4e CBF\uff0c\u4ece\u800c\u5bfc\u81f4\u8111\u7ec4\u7ec7\u4f9b\u6c27\u91cf\u51cf\u5c11\u3002<\/p>\n

\u4e00\u822c\u7684\u7ecf\u9a8c\u6cd5\u5219\u662f\uff0c\u52a8\u8109\u4e8c\u6c27\u5316\u78b3\u5206\u538b\uff08PaCO2\uff09\u6bcf\u53d8\u5316 1 mmHg\uff0cCBF \u5927\u7ea6\u53d8\u5316 1-2 mL\/100g\/min\u3002\u5728 PaCO2 \u7684\u751f\u7406\u8303\u56f4\u5185\uff08\u7ea6 20-80 mmHg\uff09\uff0c\u8fd9\u79cd\u5173\u7cfb\u901a\u5e38\u662f\u7ebf\u6027\u7684\u3002\u8fd9\u79cd\u5173\u7cfb\u7684\u6570\u5b66\u8868\u8fbe\u5f0f\u901a\u5e38\u4e3a \u0394CBF = k \u00d7 \u0394PaCO2\u3002\u5176\u4e2d\uff1a\u0394CBF \u662f CBF \u7684\u53d8\u5316\uff08\u5355\u4f4d\u4e3a mL\/100g\/min\uff09\uff0c\u0394PaCO2 \u662f PaCO2 \u7684\u53d8\u5316\uff08\u5355\u4f4d\u4e3a mmHg\uff09\uff0ck \u662f\u4e00\u4e2a\u5e38\u6570\uff0c\u8868\u793a CBF \u5bf9 PaCO2 \u53d8\u5316\u7684\u654f\u611f\u5ea6\uff0c\u901a\u5e38\u4ecb\u4e8e\u6bcf mmHg 1-2 mL\/100g\/min \u4e4b\u95f4\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8fd9\u79cd\u5173\u7cfb\u5728\u67d0\u4e9b\u75c5\u7406\u60c5\u51b5\u4e0b\u4f1a\u53d1\u751f\u6539\u53d8\uff0c\u6162\u6027\u9ad8\u78b3\u9178\u8840\u75c7\u6216\u4e25\u91cd\u8111\u8840\u7ba1\u75be\u75c5\u60a3\u8005\u7684 CBF \u5bf9 PaCO2 \u7684\u53cd\u5e94\u53ef\u80fd\u4f1a\u51cf\u5f31\u3002<\/p>\n

\u53e6\u4e00\u65b9\u9762\uff0c\u6c27\u6c14\u5bf9\u8111\u8840\u7ba1\u7684\u5f71\u54cd\u4e0e\u4e8c\u6c27\u5316\u78b3\u76f8\u53cd\u3002\u7f3a\u6c27\u6216\u4f4e\u6c27\u4f1a\u5bfc\u81f4\u8111\u8840\u7ba1\u6269\u5f20\uff0c\u4ece\u800c\u6539\u5584\u5bf9\u8111\u7ec4\u7ec7\u7684\u4f9b\u6c27\u3002\u8fd9\u662f\u4e00\u79cd\u91cd\u8981\u7684\u9002\u5e94\u6027\u53cd\u5e94\uff0c\u53ef\u786e\u4fdd\u795e\u7ecf\u7ec6\u80de\u5728\u6c27\u6c14\u4f9b\u5e94\u51cf\u5c11\u7684\u72b6\u6001\u4e0b\u4ecd\u80fd\u5b58\u6d3b\u3002\u76f8\u53cd\uff0c\u9ad8\u6c27\u6216\u9ad8\u6c27\u6c34\u5e73\u4f1a\u5f15\u8d77\u8111\u8840\u7ba1\u6536\u7f29\uff0c\u5bfc\u81f4 CBF \u964d\u4f4e\u3002\u8fd9\u79cd\u673a\u5236\u53ef\u9632\u6b62\u8111\u7ec4\u7ec7\u8fc7\u5ea6\u704c\u6ce8\uff0c\u6709\u52a9\u4e8e\u7ef4\u6301\u5927\u8111\u7684\u6700\u4f73\u4f9b\u6c27\u91cf\u3002\u6c27\u6c14\u548c\u4e8c\u6c27\u5316\u78b3\u5728\u5927\u8111\u81ea\u52a8\u8c03\u8282\u4e2d\u7684\u76f8\u4e92\u4f5c\u7528\u662f\u4e00\u79cd\u5fae\u5999\u7684\u52a8\u6001\u5e73\u8861\uff0c\u53ef\u786e\u4fdd\u6700\u4f73\u7684\u8840\u6db2\u4f9b\u5e94\u3001\u8425\u517b\u8f93\u9001\u548c\u5927\u8111\u5e9f\u7269\u6e05\u9664\u3002<\/p>\n

\u52a8\u8109\u8840\u6c27\u5206\u538b\uff08PaO2\uff09\u548c CBF \u4e4b\u95f4\u7684\u5173\u7cfb\u4e0d\u5982 PaCO2 \u548c CBF \u4e4b\u95f4\u7684\u5173\u7cfb\u90a3\u4e48\u7b80\u5355\u660e\u4e86\u3002\u4e0d\u8fc7\uff0c\u4eba\u4eec\u5bf9 PaO2 \u7684\u53d8\u5316\u5982\u4f55\u5f71\u54cd CBF \u5df2\u7ecf\u6709\u4e86\u4e00\u4e2a\u666e\u904d\u7684\u8ba4\u8bc6\uff0c\u5c3d\u7ba1\u5177\u4f53\u7684\u5b9a\u91cf\u5173\u7cfb\u53ef\u80fd\u56e0\u4eba\u800c\u5f02\uff0c\u4e5f\u53ef\u80fd\u5728\u4e0d\u540c\u7684\u751f\u7406\u548c\u75c5\u7406\u6761\u4ef6\u4e0b\u53d1\u751f\u53d8\u5316\u3002\u4e00\u822c\u6765\u8bf4\uff0c\u5728\u6b63\u5e38 PaO2 \u6c34\u5e73\u7684\u8f83\u5927\u8303\u56f4\u5185\uff0cCBF \u4fdd\u6301\u76f8\u5bf9\u7a33\u5b9a\u3002\u7136\u800c\uff0c\u5f53 PaO2 \u4e0b\u964d\u5230\u4e34\u754c\u9608\u503c\u4ee5\u4e0b\u65f6\uff08\u901a\u5e38\u7ea6\u4e3a 50-60 mmHg\uff09\uff0cCBF \u5f00\u59cb\u663e\u8457\u589e\u52a0\uff0c\u4f5c\u4e3a\u4e00\u79cd\u4ee3\u507f\u673a\u5236\uff0c\u4ee5\u7ef4\u6301\u5411\u5927\u8111\u8f93\u9001\u8db3\u591f\u7684\u6c27\u3002\u8fd9\u79cd\u5173\u7cfb\u901a\u5e38\u662f\u975e\u7ebf\u6027\u7684\uff0c\u53ef\u8868\u793a\u5982\u4e0b\uff1aCBF \u221d [1\/\uff08PaO2 \u00d7 n\uff09]\u3002\u8fd9\u91cc\uff0cn \u662f\u4e00\u4e2a\u5e38\u6570\uff0c\u51b3\u5b9a\u4e86 CBF \u5bf9 PaO2 \u53d8\u5316\u7684\u654f\u611f\u5ea6\u3002\u8be5\u7b49\u5f0f\u8868\u660e\uff0c\u968f\u7740 PaO2 \u7684\u964d\u4f4e\uff0cCBF \u4f1a\u589e\u52a0\uff0c\u4f46\u5f53 PaO2 \u964d\u81f3\u4e34\u754c\u9608\u503c\u4ee5\u4e0b\u65f6\uff0cCBF \u7684\u53d8\u5316\u901f\u5ea6\u4f1a\u52a0\u5feb\u3002n \u7684\u786e\u5207\u503c\u53ef\u80fd\u4f1a\u6709\u6240\u4e0d\u540c\uff0c\u901a\u5e38\u6839\u636e\u7ecf\u9a8c\u786e\u5b9a\u3002\u4e00\u822c\u6765\u8bf4\uff0c\u5728\u6b63\u5e38 PaO2 \u6c34\u5e73\u7684\u8f83\u5927\u8303\u56f4\u5185\uff0cCBF \u4fdd\u6301\u76f8\u5bf9\u7a33\u5b9a\u3002\u7136\u800c\uff0c\u5f53 PaO2 \u964d\u5230\u4e34\u754c\u9608\u503c\u4ee5\u4e0b\u65f6\uff08\u901a\u5e38\u7ea6\u4e3a 50-60 mmHg\uff09\uff0cCBF \u5f00\u59cb\u663e\u8457\u589e\u52a0\uff0c\u4f5c\u4e3a\u4e00\u79cd\u4ee3\u507f\u673a\u5236\uff0c\u4ee5\u7ef4\u6301\u5411\u5927\u8111\u8f93\u9001\u8db3\u591f\u7684\u6c27\u3002<\/p>\n

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\u795e\u7ecf\u5143\u53cd\u5e94<\/p>\n

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\u8111\u80fd\u91cf\u5b66<\/p>\n

\u5728\u6982\u5ff5\u5316 CBF\u3001\u81ea\u52a8\u8c03\u8282\u53ca\u5176\u538b\u529b\u6d41\u5173\u7cfb\u4ee5\u66f4\u597d\u5730\u7406\u89e3\u795e\u7ecf\u7269\u7406\u5b66\u4e4b\u540e\uff0c\u5f53\u52a1\u4e4b\u6025\u662f\u4ece\u52a8\u8109\u901a\u8fc7\u6bdb\u7ec6\u8840\u7ba1\u5e8a\u8fdb\u5165\u7ec6\u80de\u3002\u8111\u80fd\u91cf\u5b66\u5305\u62ec\u5bf9\u5927\u8111\u80fd\u91cf\u4ee3\u8c22\u7684\u7814\u7a76\uff0c\u8fd9\u662f\u5927\u8111\u529f\u80fd\u548c\u5bf9\u635f\u4f24\u53cd\u5e94\u7684\u4e00\u4e2a\u91cd\u8981\u65b9\u9762\u3002\u5982\u524d\u6240\u8ff0\uff0c\u5927\u8111\u867d\u7136\u53ea\u5360\u4f53\u91cd\u7684 2%\uff0c\u4f46\u5176\u80fd\u91cf\u6d88\u8017\u5374\u7ea6\u5360\u4eba\u4f53\u603b\u80fd\u91cf\u6d88\u8017\u7684 20%\u3002\u8fd9\u79cd\u9ad8\u9700\u6c42\u4e3b\u8981\u662f\u7531\u4e8e\u7a81\u89e6\u4f20\u9012\u548c\u7ef4\u6301\u795e\u7ecf\u5143\u819c\u4e0a\u79bb\u5b50\u68af\u5ea6\u7684\u80fd\u91cf\u5bc6\u96c6\u8fc7\u7a0b\u3002\u5927\u8111\u7684\u4e3b\u8981\u80fd\u91cf\u57fa\u8d28\u662f\u8461\u8404\u7cd6\uff0c\u901a\u8fc7\u6709\u6c27\u7cd6\u9175\u89e3\u4ee3\u8c22\u4ea7\u751f ATP\uff0c\u8fd9\u662f\u7ec6\u80de\u7684\u4e3b\u8981\u80fd\u91cf\u8d27\u5e01\u3002\u5927\u8111\u5bf9\u8461\u8404\u7cd6\u7684\u4f9d\u8d56\u6027\u975e\u5e38\u5927\uff0c\u8461\u8404\u7cd6\u4ee3\u8c22\u7684\u6539\u53d8\u4f1a\u5bf9\u795e\u7ecf\u529f\u80fd\u4ea7\u751f\u6df1\u8fdc\u5f71\u54cd\uff0c\u5e76\u4e0e\u5404\u79cd\u795e\u7ecf\u75c5\u7406\u5b66\u6709\u5173\uff0c\u5305\u62ec\u795e\u7ecf\u9000\u884c\u6027\u75be\u75c5\u548c\u8111\u635f\u4f24\u3002<\/p>\n

\u6c27\u6c14\u5bf9\u5927\u8111\u4e2d\u8461\u8404\u7cd6\u7684\u6709\u6c27\u4ee3\u8c22\u81f3\u5173\u91cd\u8981\u3002CBF \u4e0e\u4ee3\u8c22\u9700\u6c42\u4e4b\u95f4\u7684\u7d27\u5bc6\u8026\u8054\u786e\u4fdd\u4e86\u6c27\u6c14\u7684\u6301\u7eed\u4f9b\u5e94\uff0c\u5e76\u80fd\u9002\u5e94\u795e\u7ecf\u5143\u6d3b\u52a8\u7684\u65f6\u7a7a\u53d8\u5316\u3002\u8fd9\u79cd\u5173\u7cfb\u662f\u5927\u8111\u81ea\u52a8\u8c03\u8282\u7684\u57fa\u7840\uff0c\u5728\u4ee3\u8c22\u9700\u6c42\u6216\u8840\u6d41\u91cf\u53d1\u751f\u53d8\u5316\u7684\u75c5\u7406\u60c5\u51b5\u4e0b\u4f1a\u53d7\u5230\u5f71\u54cd\u3002\u6700\u8fd1\u7684\u795e\u7ecf\u80fd\u91cf\u5b66\u7814\u7a76\u5df2\u5f00\u59cb\u9610\u660e\u80fd\u91cf\u4ee3\u8c22\u3001\u5927\u8111\u529f\u80fd\u548c\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\u4e4b\u95f4\u7684\u8054\u7cfb\u3002\u4f8b\u5982\uff0c\u5728\u7f3a\u8840\u6027\u5352\u4e2d\u6216\u521b\u4f24\u6027\u8111\u635f\u4f24\u7b49\u60c5\u51b5\u4e0b\uff0c\u80fd\u91cf\u4ee3\u8c22\u7d0a\u4e71\u4f1a\u5bfc\u81f4\u795e\u7ecf\u5143\u529f\u80fd\u969c\u788d\u548c\u6b7b\u4ea1\u3002\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u662f\u8bb8\u591a\u795e\u7ecf\u9000\u884c\u6027\u75be\u75c5\u7684\u4e3b\u8981\u7279\u5f81\uff0c\u4f1a\u5bfc\u81f4\u80fd\u91cf\u4e0d\u8db3\u548c\u795e\u7ecf\u5143\u9000\u5316\u3002\u4ee5\u6539\u5584\u7ebf\u7c92\u4f53\u529f\u80fd\u6216\u4fdd\u62a4\u7ebf\u7c92\u4f53\u514d\u53d7\u635f\u4f24\u4e3a\u91cd\u70b9\u7684\u7814\u7a76\u4e3a\u5404\u79cd\u795e\u7ecf\u75be\u75c5\u7684\u6cbb\u7597\u5e72\u9884\u5e26\u6765\u4e86\u5e0c\u671b\u3002<\/p>\n

\u5728\u5065\u5eb7\u7684\u5927\u8111\u4e2d\uff0c\u795e\u7ecf\u5143\u6d3b\u52a8\u4e0e CBF \u4e4b\u95f4\u5b58\u5728\u7d27\u5bc6\u7684\u8026\u8054\u5173\u7cfb\uff0c\u4ee5\u786e\u4fdd\u4e3a\u6d3b\u8dc3\u7684\u795e\u7ecf\u5143\u63d0\u4f9b\u5145\u8db3\u7684\u8461\u8404\u7cd6\u548c\u6c27\u3002\u8fd9\u5bf9\u4e8e\u7ef4\u6301\u79bb\u5b50\u68af\u5ea6\u548c\u795e\u7ecf\u9012\u8d28\u5faa\u73af\u81f3\u5173\u91cd\u8981\uff0c\u800c\u79bb\u5b50\u68af\u5ea6\u548c\u795e\u7ecf\u9012\u8d28\u5faa\u73af\u662f\u80fd\u91cf\u5bc6\u96c6\u578b\u8fc7\u7a0b\u3002\u5728\u6025\u6027\u8111\u635f\u4f24\uff08\u5982\u521b\u4f24\u6027\u8111\u635f\u4f24\u6216\u5352\u4e2d\uff09\u671f\u95f4\uff0c\u6b63\u5e38\u7684\u795e\u7ecf\u4ee3\u8c22\u8026\u8054\u4f1a\u88ab\u7834\u574f\u3002\u8fd9\u79cd\u7834\u574f\u4f1a\u5bfc\u81f4\u795e\u7ecf\u4ee3\u8c22\u65ad\u88c2\uff0c\u5373\u795e\u7ecf\u5143\u80fd\u91cf\u9700\u6c42\u4e0e\u5fc5\u9700\u5e95\u7269\uff08\u6c27\u548c\u8461\u8404\u7cd6\uff09\u4f9b\u5e94\u4e0d\u5339\u914d\u7684\u72b6\u6001\u3002<\/p>\n

\u8111\u635f\u4f24\u4e2d\u7684\u795e\u7ecf\u4ee3\u8c22\u8026\u8054\u53ef\u7531\u591a\u79cd\u56e0\u7d20\u5bfc\u81f4\uff1a(1) CBF \u964d\u4f4e\u5bfc\u81f4\u7f3a\u8840\u548c\u6c27\u6c14\/\u8461\u8404\u7cd6\u4f9b\u5e94\u4e0d\u8db3\uff1b(2) \u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u5f71\u54cd ATP \u7684\u4ea7\u751f\uff1b(3) \u7ec6\u80de\u4fee\u590d\u8fc7\u7a0b\u5bfc\u81f4\u80fd\u91cf\u9700\u6c42\u589e\u52a0\u6216\u5174\u594b\u6027\u6bd2\u6027\u52a0\u5267\uff1b\u4ee5\u53ca (4) \u8840\u8111\u5c4f\u969c\u7834\u574f\u5bfc\u81f4\u5e95\u7269\u8f93\u9001\u53d1\u751f\u6539\u53d8\u3002\u795e\u7ecf\u4ee3\u8c22\u5931\u8026\u8054\u7684\u540e\u679c\u5305\u62ec\u80fd\u91cf\u4e0d\u8db3\u3001\u4e73\u9178\u5806\u79ef\uff08\u7531\u4e8e\u65e0\u6c27\u4ee3\u8c22\uff09\u3001\u7ec6\u80de\u6c34\u80bf\u3001\u6c27\u5316\u5e94\u6fc0\uff0c\u6700\u7ec8\u5bfc\u81f4\u795e\u7ecf\u5143\u6b7b\u4ea1\u3002\u5728\u521b\u4f24\u6027\u8111\u635f\u4f24\u7b49\u60c5\u51b5\u4e0b\uff0c\u635f\u4f24\u5468\u56f4\u533a\u57df\uff08\u534a\u6697\u5e26\uff09\u7279\u522b\u5bb9\u6613\u53d7\u5230\u795e\u7ecf\u4ee3\u8c22\u5931\u8026\u8054\u7684\u5f71\u54cd\u3002\u65b0\u9648\u4ee3\u8c22\u5931\u8c03\u4f1a\u52a0\u5267\u8be5\u533a\u57df\u7684\u4e8c\u6b21\u635f\u4f24\u8fc7\u7a0b\u3002\u4f8b\u5982\uff0c\u521b\u4f24\u6027\u8111\u635f\u4f24\u540e\u4f1a\u51fa\u73b0\u5927\u8111\u9ad8\u7cd6\u9175\u89e3\u73b0\u8c61\uff0c\u5373\u4f7f\u5728\u6c27\u4f9b\u5e94\u5145\u8db3\u7684\u60c5\u51b5\u4e0b\uff0c\u8111\u7ec6\u80de\u6d88\u8017\u8461\u8404\u7cd6\u7684\u901f\u5ea6\u4ecd\u9ad8\u4e8e\u6b63\u5e38\u6c34\u5e73\u3002\u8fd9\u88ab\u8ba4\u4e3a\u662f\u53d7\u4f24\u5927\u8111\u5728\u819c\u4fee\u590d\u3001\u79bb\u5b50\u5e73\u8861\u548c\u708e\u75c7\u7b49\u8fc7\u7a0b\u4e2d\u80fd\u91cf\u9700\u6c42\u589e\u52a0\u7684\u4e00\u79cd\u53cd\u5e94\u3002\u6cbb\u7597\u7b56\u7565\u901a\u5e38\u65e8\u5728\u6062\u590d\u80fd\u91cf\u4f9b\u9700\u5e73\u8861\uff0c\u5982\u786e\u4fdd\u5145\u8db3\u7684\u8111\u704c\u6ce8\u3001\u4f7f\u7528\u795e\u7ecf\u4fdd\u62a4\u5242\u51cf\u8f7b\u5174\u594b\u6bd2\u6027\u548c\u652f\u6301\u7ebf\u7c92\u4f53\u529f\u80fd\u3002CMD \u548c PET \u6210\u50cf\u53ef\u8fdb\u4e00\u6b65\u6df1\u5165\u4e86\u89e3\u8111\u80fd\u91cf\uff0c\u672c\u624b\u7a3f\u5c06\u5bf9\u6b64\u8fdb\u884c\u66f4\u8be6\u7ec6\u7684\u63a2\u8ba8\u3002<\/p>\n

\u56db<\/p>\n

\u4fb5\u5165\u6027\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177<\/p>\n

\u5c06\u6982\u8ff0\u6cbb\u7597\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u548c\u6025\u6027\u8111\u635f\u4f24\u7684\u5404\u79cd\u6709\u521b\u548c\u65e0\u521b\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177\u3001\u9002\u5e94\u75c7\u3001\u65b9\u6cd5\u548c\u751f\u7406\u57fa\u7840\uff08\u56fe 2\uff09\u3002<\/p>\n

\u56fe 2 \u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u548c\u6025\u6027\u8111\u635f\u4f24\u6cbb\u7597\u4e2d\u5404\u79cd\u6709\u521b\u548c\u65e0\u521b\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177\u3001\u9002\u5e94\u75c7\u3001\u65b9\u6cd5\u548c\u751f\u7406\u57fa\u7840\u7684\u6982\u89c8\u3002EEG\uff1a\u8111\u7535\u56fe\uff1bICPwf\uff1a\u9885\u5185\u538b\u6ce2\u5f62<\/p>\n

ICP\u76d1\u6d4b\u548c\u6ce2\u5f62\u5206\u6790<\/p>\n

\u8111\u5ba4\u5916\u5f15\u6d41\u7ba1\uff08EVD\uff09\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u7ba1\u7406 ICP \u548c\u8111\u79ef\u6c34\u7684\u91cd\u8981\u5de5\u5177\u3002EVD \u662f\u6d4b\u91cf ICP \u7684\u76f4\u63a5\u65b9\u6cd5\uff0c\u53ef\u5f15\u6d41 CSF \u4ee5\u7f13\u89e3\u9885\u7a79\u5185\u5347\u9ad8\u7684\u538b\u529b\u3002\u8fd9\u79cd\u65b9\u6cd5\u5bf9\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u5c24\u4e3a\u91cd\u8981\uff0c\u56e0\u4e3a\u5728\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0cICP \u7684\u5feb\u901f\u53d8\u5316\u4f1a\u5bf9\u60a3\u8005\u7684\u9884\u540e\u4ea7\u751f\u91cd\u5927\u5f71\u54cd\u3002\u653e\u7f6e EVD \u9700\u8981\u5c06\u5bfc\u7ba1\u63d2\u5165\u4fa7\u8111\u5ba4\uff0c\u901a\u5e38\u9700\u8981\u5728\u795e\u7ecf\u5f71\u50cf\u7684\u5f15\u5bfc\u4e0b\u8fdb\u884c\uff0c\u4ee5\u786e\u4fdd\u5b9a\u4f4d\u51c6\u786e\u3002\u5bfc\u7ba1\u4e0e\u5916\u90e8\u4f20\u611f\u5668\u76f8\u8fde\uff0c\u540e\u8005\u53ef\u63d0\u4f9b\u8fde\u7eed\u7684 ICP \u8bfb\u6570\uff0c\u4ece\u800c\u4fc3\u8fdb\u5b9e\u65f6\u76d1\u6d4b\u548c\u7ba1\u7406\u3002\u901a\u8fc7 EVD \u76d1\u6d4b ICP \u5bf9\u521b\u4f24\u6027\u8111\u635f\u4f24\u3001\u5352\u4e2d\u6216\u5176\u4ed6\u5bfc\u81f4 ICP \u589e\u9ad8\u7684\u60a3\u8005\u81f3\u5173\u91cd\u8981\u3002EVD \u53ef\u53ca\u65f6\u53d1\u73b0\u548c\u5e72\u9884\u5347\u9ad8\u7684 ICP\uff0c\u5728\u9884\u9632\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u548c\u6539\u5584\u60a3\u8005\u9884\u540e\u65b9\u9762\u53d1\u6325\u7740\u91cd\u8981\u4f5c\u7528\u3002<\/p>\n

\u867d\u7136 EVD \u662f\u4e00\u79cd\u5b9d\u8d35\u7684\u5de5\u5177\uff0c\u4f46\u4e5f\u5e76\u975e\u6ca1\u6709\u98ce\u9669\u3002\u5e76\u53d1\u75c7\u5305\u62ec\u611f\u67d3\u3001\u51fa\u8840\u548c\u5bfc\u7ba1\u9519\u4f4d\u3002\u4e25\u683c\u7684\u63d2\u5165\u548c\u7ef4\u62a4\u89c4\u7a0b\u5bf9\u6700\u5927\u9650\u5ea6\u5730\u964d\u4f4e\u8fd9\u4e9b\u98ce\u9669\u81f3\u5173\u91cd\u8981\u3002\u5c31 MMM \u800c\u8a00\uff0cEVD \u63d0\u4f9b\u7684\u91cd\u8981\u6570\u636e\u53ef\u4e0e CPP \u548c\u8111\u7ec4\u7ec7\u6c27\u5408\u6d4b\u91cf\u7b49\u5176\u4ed6\u76d1\u6d4b\u65b9\u6cd5\u6574\u5408\u3002\u8fd9\u79cd\u6574\u5408\u53ef\u63d0\u9ad8\u5bf9\u60a3\u8005\u795e\u7ecf\u72b6\u6001\u7684\u4e86\u89e3\uff0c\u5e76\u6307\u5bfc\u6cbb\u7597\u5e72\u9884\u3002\u6b64\u5916\uff0cEVD \u8fd8\u53ef\u901a\u8fc7 ICP \u6ce2\u5f62 (ICPwf) \u5206\u6790\u63d0\u4f9b\u6709\u5173 CSF \u6d41\u4f53\u529b\u5b66\u7684\u91cd\u8981\u4fe1\u606f\u3002<\/p>\n

ICPwf \u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u8be6\u7ec6\u8bc4\u4f30\u548c\u7ba1\u7406\u81f3\u5173\u91cd\u8981\u3002\u8fd9\u4e9b\u6ce2\u5f62\u901a\u5e38\u88ab\u79f0\u4e3a\u4f26\u5fb7\u4f2f\u683c\u6ce2\uff0c\u4e3b\u8981\u5206\u4e3a\u4e09\u79cd\u7c7b\u578b\uff1aA\u3001B \u548c C \u6ce2\u3002A \u6ce2\u4e5f\u79f0\u4e3a\u9ad8\u539f\u6ce2\uff0c\u5176\u7279\u5f81\u662f ICP \u7a81\u7136\u6025\u5267\u5347\u9ad8\u81f3 50-100 mmHg \u7684\u6c34\u5e73\uff0c\u6301\u7eed 5-20 \u5206\u949f\u3002\u5b83\u4eec\u901a\u5e38\u8868\u660e\u8111\u7684\u81ea\u52a8\u8c03\u8282\u529f\u80fd\u4e25\u91cd\u53d7\u635f\uff0c\u5e76\u4e0e\u4e25\u91cd\u7684\u9885\u5185\u75c5\u53d8\u6709\u5173\u3002B \u6ce2\u662f\u8f83\u5c0f\u7684 ICP \u8282\u5f8b\u6027\u632f\u8361\uff0c\u6bcf 1-2 \u5206\u949f\u51fa\u73b0\u4e00\u6b21\uff0c\u901a\u5e38\u4e0e CBF \u4e0d\u7a33\u5b9a\u6709\u5173\uff0c\u5c24\u5176\u662f\u5728\u521b\u4f24\u6027\u8111\u635f\u4f24\u6216\u8111\u79ef\u6c34\u60a3\u8005\u4e2d\u3002C \u6ce2\u662f\u66f4\u5c0f\u66f4\u9891\u7e41\u7684\u6ce2\u52a8\uff0c\u901a\u5e38\u51fa\u73b0\u5728\u6b63\u5e38\u7684 ICP \u76d1\u6d4b\u4e2d\uff0c\u53cd\u6620\u4e86\u9885\u5185\u52a8\u6001\u7684\u6b63\u5e38\u751f\u7406\u53d8\u5316\u3002<\/p>\n

\u5bf9\u8fd9\u4e9b ICPwf \u7684\u6301\u7eed\u76d1\u6d4b\u548c\u5206\u6790\u53ef\u63d0\u4f9b\u6709\u5173\u5927\u8111\u987a\u5e94\u6027\u3001\u8840\u6d41\u52a8\u6001\u548c\u60a3\u8005\u6574\u4f53\u795e\u7ecf\u72b6\u51b5\u7684\u91cd\u8981\u4fe1\u606f\uff0c\u4e3a\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u73af\u5883\u4e2d\u7684\u6cbb\u7597\u51b3\u7b56\u63d0\u4f9b\u6307\u5bfc\u3002SYNAPSE-ICU \u7814\u7a76\u8868\u660e\uff0c\u5bf9\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u8fdb\u884c\u8fde\u7eed ICP \u76d1\u6d4b\u53ef\u63d0\u9ad8\u6cbb\u7597\u8b66\u60d5\u6027\u3001\u964d\u4f4e\u6b7b\u4ea1\u7387\u5e76\u6539\u5584\u795e\u7ecf\u529f\u80fd\u9884\u540e\u3002\u6b64\u5916\uff0cICP \u589e\u9ad8\u7684\u9608\u503c\u591a\u5e74\u6765\u4e00\u76f4\u5728\u6ce2\u52a8\u30022000 \u5e74\uff0c\u8111\u5916\u4f24\u57fa\u91d1\u4f1a\u6307\u5357\u5efa\u8bae\u6b63\u5e38 ICP \u4e3a 20-25 mmHg\u30022007 \u5e74\u6539\u4e3a\u2264 20 mmHg\u3002\u6700\u8fd1\u5728 2016 \u5e74\uff0c\u8be5\u6307\u5357\u88ab\u6539\u8fdb\u4e3a ICP \u2264 22 mmHg\uff0c\u8fd9\u8868\u660e\u6b7b\u4ea1\u7387\u548c\u826f\u597d\u7684\u6cbb\u7597\u6548\u679c\u5f97\u5230\u4e86\u63d0\u9ad8\u3002<\/p>\n

G\u00fciza \u7b49\u4eba\u8bc4\u4f30\u4e86 ICP \u589e\u9ad8\u5bf9\u6210\u4eba\u548c\u513f\u7ae5\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u795e\u7ecf\u7cfb\u7edf\u9884\u540e\u7684\u5f71\u54cd\u3002\u7814\u7a76\u4eba\u5458\u5206\u6790\u4e86 261 \u540d\u6210\u4eba\u548c 99 \u540d\u513f\u7ae5\u6bcf\u5206\u949f\u7684 ICP \u548c\u8840\u538b\u6570\u636e\u3002\u6210\u4eba ICP \u8d85\u8fc7 20 mmHg \u6301\u7eed\u65f6\u95f4\u8d85\u8fc7 37 \u5206\u949f\uff0c\u513f\u7ae5\u8d85\u8fc7 8 \u5206\u949f\uff0c\u5219\u9884\u540e\u8f83\u5dee\u3002\u8be5\u7814\u7a76\u8fd8\u8bc1\u5b9e\uff0c\u968f\u7740\u65f6\u95f4\u7684\u63a8\u79fb\uff0cICP \u7684\u7d2f\u79ef\u8d1f\u62c5\u4e0e\u5df2\u77e5\u7684\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u57fa\u7ebf\u98ce\u9669\u56e0\u7d20\u76f8\u7ed3\u5408\uff0c\u662f\u9884\u6d4b\u6b7b\u4ea1\u7387\u7684\u4e00\u4e2a\u72ec\u7acb\u56e0\u7d20\u3002\u6b64\u5916\uff0c\u8be5\u7814\u7a76\u8fd8\u5f3a\u8c03\uff0c\u53d7\u635f\u7684\u8111\u8840\u7ba1\u81ea\u52a8\u8c03\u8282\u80fd\u529b\u6781\u5927\u5730\u9650\u5236\u4e86\u60a3\u8005\u8010\u53d7 ICP \u5347\u9ad8\u7684\u80fd\u529b\u3002\u5f53\u8111\u704c\u6ce8\u538b\u964d\u81f3 50 mmHg \u4ee5\u4e0b\u65f6\uff0cICP \u5347\u9ad8\u6301\u7eed\u65f6\u95f4\u8d8a\u957f\uff0c\u9884\u540e\u8d8a\u5dee\u3002\u8fd9\u9879\u7814\u7a76\u5f3a\u8c03\uff0c\u5c0f\u513f\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u7ee7\u53d1\u6027\u635f\u4f24\u53d1\u751f\u5728\u8f83\u4f4e\u7684ICP\u9608\u503c\uff0c\u5e76\u5f3a\u8c03\u4e86\u5c06\u8111\u704c\u6ce8\u538b\u7ef4\u6301\u572850 mmHg\u4ee5\u4e0a\u7684\u91cd\u8981\u6027\uff0c\u5c24\u5176\u662f\u5728\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u75c5\u4f8b\u4e2d\u3002\u56e0\u6b64\uff0c\u4e0d\u5e94\u5c06 ICP \u89c6\u4e3a\u4e8c\u5206\u6cd5\u7684\u6570\u503c\uff0c\u800c\u5e94\u5c06\u5176\u89c6\u4e3a\u9488\u5bf9\u6bcf\u4f4d\u60a3\u8005\u7684\u52a8\u6001\u6570\u503c\uff0c\u5e76\u8003\u8651\u5230\u5927\u8111\u81ea\u52a8\u8c03\u8282\u7684\u5b8c\u6574\u6027\u3002<\/p>\n

\u8111\u7ec4\u7ec7\u6c27\u5408\u76d1\u6d4b<\/p>\n

\u8111\u7ec4\u7ec7\u6c27\u9971\u548c\u5ea6\uff08PbtO2\uff09\u8fde\u7eed\u76d1\u6d4b\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u9886\u57df\u7684\u4e00\u9879\u91cd\u8981\u8fdb\u5c55\uff0c\u53ef\u63d0\u4f9b\u5c40\u90e8\u3001\u5b9e\u65f6\u7684\u8111\u6c27\u9971\u548c\u5ea6\u72b6\u6001\u4fe1\u606f\u3002\u8fd9\u9879\u6280\u672f\u662f\u5c06\u63a2\u9488\u63d2\u5165\u8111\u7ec4\u7ec7\uff08\u901a\u5e38\u662f\u989d\u53f6\u767d\u8d28\uff09\uff0c\u76f4\u63a5\u6d4b\u91cf\u8111\u7ec4\u7ec7\u4e2d\u7684\u6c27\u5206\u538b\u3002PbtO2 \u76d1\u6d4b\u5bf9\u4e8e\u6cbb\u7597\u521b\u4f24\u6027\u8111\u635f\u4f24\u548c\u4e2d\u98ce\u7b49\u8111\u6c27\u5408\u6709\u98ce\u9669\u7684\u60a3\u8005\u5c24\u4e3a\u91cd\u8981\u3002\u8be5\u6280\u672f\u7684\u4e3b\u8981\u7528\u9014\u5728\u4e8e\u68c0\u6d4b\u8111\u7f3a\u6c27\uff0c\u8111\u7f3a\u6c27\u662f\u6307\u8111\u7ec4\u7ec7\u4f9b\u6c27\u4e0d\u8db3\u7684\u4e00\u79cd\u72b6\u6001\uff0c\u5982\u4e0d\u53ca\u65f6\u5904\u7406\u4f1a\u5bfc\u81f4\u7ec6\u80de\u529f\u80fd\u969c\u788d\u548c\u6b7b\u4ea1\u3002\u6b63\u5e38\u7684 PbtO2 \u503c\u901a\u5e38\u5728 20-40 mmHg \u4e4b\u95f4\uff0c\u4f4e\u4e8e 10 mmHg \u8868\u793a\u4e25\u91cd\u7f3a\u6c27\u3002\u4e00\u4e9b\u7814\u7a76\u4eba\u5458\u5c06\u8111\u7ec4\u7ec7\u7f3a\u6c27\u5b9a\u4e49\u4e3a PbtO2 < 15 mmHg\uff0c\u53e6\u4e00\u4e9b\u7814\u7a76\u4eba\u5458\u5219\u5c06\u5176\u5b9a\u4e49\u4e3a PbtO2 < 20 mmHg\u3002<\/p>\n

\u901a\u8fc7\u6301\u7eed\u76d1\u6d4b PbtO2\uff0c\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u533b\u5e08\u53ef\u4ee5\u8c03\u6574\u6cbb\u7597\u5e72\u9884\u63aa\u65bd\uff0c\u5305\u62ec\u4f18\u5316 CPP \u548c\u8c03\u6574\u901a\u6c14\u7b56\u7565\u3002\u5b83\u901a\u5e38\u4e0e\u5176\u4ed6\u795e\u7ecf\u76d1\u6d4b\u65b9\u6cd5\uff08\u5982 ICP \u76d1\u6d4b\u548c CMD\uff09\u4e00\u8d77\u4f7f\u7528\uff0c\u4ee5\u63d0\u4f9b\u5927\u8111\u72b6\u6001\u7684\u7efc\u5408\u89c6\u56fe\u3002\u5c3d\u7ba1 PbtO2 \u76d1\u6d4b\u6709\u5f88\u591a\u4f18\u70b9\uff0c\u4f46\u5b83\u53ea\u80fd\u6d4b\u91cf\u6709\u9650\u8111\u533a\u7684\u6c27\u5408\u60c5\u51b5\uff0c\u800c\u4e14\u7531\u4e8e\u662f\u4fb5\u5165\u6027\u7684\uff0c\u56e0\u6b64\u5b58\u5728\u611f\u67d3\u548c\u51fa\u8840\u7b49\u98ce\u9669\u3002\u4e0d\u8fc7\uff0c\u4f20\u611f\u5668\u6280\u672f\u7684\u8fdb\u6b65\u6b63\u5728\u63d0\u9ad8\u5176\u51c6\u786e\u6027\u548c\u5e94\u7528\u8303\u56f4\uff0c\u4e3a\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u66f4\u4e2a\u6027\u5316\u7684\u6cbb\u7597\u65b9\u6cd5\u94fa\u5e73\u4e86\u9053\u8def\u3002<\/p>\n

\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u9636\u6bb5\u7684\u8111\u6c27\u4f18\u5316\uff08BOOST\uff09-1 \u548c BOOST-2 \u7814\u7a76\u6781\u5927\u5730\u63a8\u52a8\u4e86\u6211\u4eec\u5bf9\u6cbb\u7597\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u8fc7\u7a0b\u4e2d\u8111\u7ec4\u7ec7\u6c27\u5408\u60c5\u51b5\u7684\u4e86\u89e3\u3002BOOST-1\u662f\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\uff0c\u5b83\u786e\u5b9a\u4e86\u76d1\u6d4b\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005PbtO2\u7684\u53ef\u884c\u6027\uff0c\u5f3a\u8c03\u4e86\u8f83\u4f4e\u6c34\u5e73\u7684PbtO2\u4e0e\u8f83\u5dee\u9884\u540e\u4e4b\u95f4\u7684\u76f8\u5173\u6027\u3002\u8fd9\u9879\u7814\u7a76\u5f3a\u8c03\u4e86\u5728\u6cbb\u7597\u521b\u4f24\u6027\u8111\u635f\u4f24\u8fc7\u7a0b\u4e2d\u4fdd\u6301\u8111\u7ec4\u7ec7\u5145\u5206\u4f9b\u6c27\u7684\u6f5c\u5728\u91cd\u8981\u6027\u3002<\/p>\n

\u5728\u6b64\u57fa\u7840\u4e0a\uff0c\u968f\u673a\u4e34\u5e8a\u8bd5\u9a8c BOOST-2 \u7814\u7a76\u8fdb\u4e00\u6b65\u8bc4\u4f30\u4e86 PbtO2 \u5f15\u5bfc\u7597\u6cd5\u3002\u7814\u7a76\u7ed3\u679c\u8868\u660e\uff0c\u5c06 PbtO2 \u7ef4\u6301\u5728\u9608\u503c\u4ee5\u4e0a\u7684\u7ba1\u7406\u65b9\u6848\u662f\u53ef\u884c\u4e14\u5b89\u5168\u7684\uff0c\u8fd9\u8868\u660e\u795e\u7ecf\u7cfb\u7edf\u7684\u9884\u540e\u53ef\u80fd\u4f1a\u6709\u6240\u6539\u5584\uff0c\u4f46\u8be5\u7814\u7a76\u5e76\u672a\u6700\u7ec8\u786e\u5b9a\u8fd9\u79cd\u76ca\u5904\uff0c\u8fd9\u8868\u660e\u9700\u8981\u8fdb\u884c\u66f4\u591a\u7684\u8bd5\u9a8c\u3002\u4e3a\u6b64\uff0c\u6b63\u5728\u8fdb\u884c\u7684 BOOST-3 \u8bd5\u9a8c\u65e8\u5728\u63d0\u4f9b\u66f4\u786e\u5207\u7684\u8bc1\u636e\u3002\u8fd9\u9879\u5927\u89c4\u6a21\u7814\u7a76\u63a2\u8ba8\u4e86\u5728\u8fdb\u884c ICP \u76d1\u6d4b\u7684\u540c\u65f6\u4f7f\u7528 PbtO2 \u76d1\u6d4b\u5bf9\u4e25\u91cd TBI \u60a3\u8005\u8fdb\u884c\u7ba1\u7406\u662f\u5426\u4f1a\u6bd4\u5355\u7eaf\u4f9d\u9760 ICP \u76d1\u6d4b\u83b7\u5f97\u66f4\u597d\u7684\u7597\u6548\u3002\u6211\u4eec\u70ed\u5207\u671f\u5f85 BOOST-3 \u7684\u7ed3\u679c\uff0c\u56e0\u4e3a\u5b83\u4eec\u6709\u53ef\u80fd\u6781\u5927\u5730\u5f71\u54cd\u4e25\u91cd TBI \u60a3\u8005\u7684\u6cbb\u7597\u6807\u51c6\u3002<\/p>\n

SjvO2<\/p>\n

SjvO2\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u7684\u4e00\u79cd\u96c6\u6210\u76d1\u6d4b\u5de5\u5177\uff0c\u901a\u8fc7\u6d4b\u91cf\u4ece\u5927\u8111\u6392\u51fa\u7684\u9759\u8109\u8840\u4e2d\u7684\u6c27\u9971\u548c\u5ea6\uff0c\u4e3a\u4e86\u89e3\u5168\u5927\u8111\u6c27\u5408\u72b6\u6001\u63d0\u4f9b\u4e86\u81f3\u5173\u91cd\u8981\u7684\u89c1\u89e3\u3002\u8be5\u6280\u672f\u5305\u62ec\u5c06\u5bfc\u7ba1\u63d2\u5165\u9888\u5185\u9759\u8109\u4ee5\u8fde\u7eed\u76d1\u6d4bSjvO2\u3002SjvO2\u4f5c\u4e3a\u5927\u8111\u6c27\u6c14\u4f9b\u5e94\u548c\u9700\u6c42\u4e4b\u95f4\u5e73\u8861\u7684\u95f4\u63a5\u6307\u6807\u3002\u901a\u5e38\uff0cSjvO2\u503c\u572855%-75%\u4e4b\u95f4\uff0c\u4f4e\u4e8e55%\u7684\u503c\u8868\u660e\u6f5c\u5728\u7684\u8111\u7f3a\u8840\u6216\u7f3a\u6c27\uff0c\u8868\u660e\u5927\u8111\u7684\u4ee3\u8c22\u9700\u6c42\u6ca1\u6709\u5f97\u5230\u5145\u5206\u6ee1\u8db3\u3002<\/p>\n

\u8fd9\u79cd\u76d1\u6d4b\u5728TBI\u3001\u86db\u7f51\u819c\u4e0b\u8154\u51fa\u8840\uff08SAH\uff09\u6216\u4e25\u91cd\u7f3a\u8840\u60a3\u8005\u4e2d\u5c24\u5176\u91cd\u8981\uff0c\u56e0\u4e3a\u5b83\u6709\u52a9\u4e8e\u68c0\u6d4b\u8111\u6c27\u5408\u7684\u5173\u952e\u53d8\u5316\uff0c\u5e76\u6307\u5bfc\u6cbb\u7597\u51b3\u7b56\uff0c\u5982\u547c\u5438\u673a\u8c03\u6574\u548c\u704c\u6ce8\u7ba1\u7406\u3002\u5bfc\u7ba1\u901a\u5e38\u653e\u7f6e\u5728\u4e3b\u8981\u9888\u9759\u8109\u4e2d\uff0c\u901a\u8fc7\u6210\u50cf\u6216\u4e34\u5e8a\u8bc4\u4f30\u786e\u5b9a\uff0c\u4ee5\u786e\u4fdd\u51c6\u786e\u6d4b\u91cf\u8111\u9759\u8109\u6d41\u51fa\u91cf\u3002<\/p>\n

\u5c3d\u7ba1SjvO2\u63d0\u4f9b\u4e86\u5173\u4e8e\u8111\u6c27\u5408\u7684\u8fde\u7eed\u3001\u5168\u5c40\u4fe1\u606f\uff0c\u4f46\u5b83\u786e\u5b9e\u6709\u5c40\u9650\u6027\uff0c\u5305\u62ec\u65e0\u6cd5\u63d0\u4f9b\u533a\u57df\u6570\u636e\uff0c\u4ee5\u53ca\u7531\u4e8e\u60a3\u8005\u5b9a\u4f4d\u6216\u9885\u5916\u6c61\u67d3\u800c\u5bb9\u6613\u51fa\u73b0\u4e0d\u51c6\u786e\u7684\u60c5\u51b5\u3002\u5c3d\u7ba1\u5b58\u5728\u8fd9\u4e9b\u5c40\u9650\u6027\uff0c\u4f46\u5b83\u5728\u52a8\u6001\u8bc4\u4f30\u8111\u6c27\u5408\u65b9\u9762\u7684\u4f5c\u7528\u4f7f\u5176\u6210\u4e3a\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u7684\u4e00\u4e2a\u6709\u4ef7\u503c\u7684\u5de5\u5177\u3002\u76ee\u524d\u7684\u7814\u7a76\u5de5\u4f5c\u65e8\u5728\u63d0\u9ad8\u5176\u51c6\u786e\u6027\uff0c\u5e76\u5c06\u5176\u4e0e\u5176\u4ed6\u795e\u7ecf\u76d1\u6d4b\u65b9\u6cd5\u76f8\u7ed3\u5408\uff0c\u4e30\u5bcc\u6574\u4f53\u60a3\u8005\u6cbb\u7597\u7b56\u7565\u3002<\/p>\n

TDF\u4e0e\u5c40\u90e8\u8111\u8840\u6d41<\/p>\n

TDF\u5728\u795e\u7ecf\u5371\u91cd\u75c7\u6551\u6cbb\u4e2d\u63d0\u4f9b\u4e86\u4e00\u79cd\u72ec\u7279\u7684\u65b9\u6cd5\u6765\u8bc4\u4f30\u5c40\u90e8\u8111\u8840\u6d41\u91cf\uff08rCBF\uff09\uff0c\u5c24\u5176\u662f\u5bf9TBI\u6216\u8111\u8840\u7ba1\u75be\u75c5\u60a3\u8005\u81f3\u5173\u91cd\u8981\u3002\u8fd9\u9879\u6280\u672f\u5305\u62ec\u5728\u8111\u7ec4\u7ec7\u4e2d\u653e\u7f6e\u4e00\u4e2a\u4e13\u95e8\u7684\u63a2\u9488\uff0c\u6839\u636e\u70ed\u6269\u6563\u539f\u7406\u6d4b\u91cf\u8840\u6db2\u6d41\u91cf\u3002\u63a2\u5934\u7531\u4e00\u4e2a\u52a0\u70ed\u5668\u548c\u4e00\u4e2a\u6e29\u5ea6\u4f20\u611f\u5668\u7ec4\u6210\uff1b\u52a0\u70ed\u5668\u7684\u6563\u70ed\u53d7\u5230\u76f8\u90bb\u8111\u7ec4\u7ec7\u4e2d\u7684\u8840\u6d41\u7684\u5f71\u54cd\u4ece\u800c\u63d0\u4f9brCBF\u7684\u6d4b\u91cf\u3002TDF\u56e0\u5176\u80fd\u591f\u63d0\u4f9b\u5bf9\u5c40\u90e8CBF\u7684\u8fde\u7eed\u3001\u5b9e\u65f6\u76d1\u6d4b\u800c\u5907\u53d7\u91cd\u89c6\uff0c\u4f7f\u4e34\u5e8a\u533b\u751f\u80fd\u591f\u7acb\u5373\u68c0\u6d4b\u5927\u8111\u704c\u6ce8\u7684\u53d8\u5316\u5e76\u5bf9\u5176\u505a\u51fa\u53cd\u5e94\u3002\u6b63\u5e38rCBF\u503c\u8303\u56f4\u4e3a20\u81f330mL\/100g\/min\uff0c\u504f\u79bb\u8be5\u8303\u56f4\u53ef\u6307\u793a\u75c5\u7406\u72b6\u51b5\u3002\u4f8b\u5982\uff0crCBF\u964d\u4f4e\u53ef\u80fd\u662f\u7f3a\u8840\u7684\u4fe1\u53f7\uff0c\u800c\u8fc7\u9ad8\u7684\u503c\u53ef\u80fd\u8868\u793a\u5145\u8840\uff0c\u8fd9\u4e24\u79cd\u60c5\u51b5\u90fd\u9700\u8981\u7acb\u5373\u5c31\u533b\u3002TDF\u6301\u7eed\u76d1\u6d4brCBF\u7684\u80fd\u529b\u6709\u52a9\u4e8e\u6307\u5bfc\u6cbb\u7597\u5e72\u9884\u63aa\u65bd\uff0c\u5982\u4f18\u5316\u8111\u704c\u6ce8\u538b\u529b\u548c\u7ba1\u7406ICP\u3002\u5c3d\u7ba1TDF\u6709\u597d\u5904\uff0c\u4f46\u5b83\u786e\u5b9e\u6709\u5c40\u9650\u6027\uff0c\u5305\u62ec\u5176\u4fb5\u5165\u6027\u548c\u7531\u4e8e\u63a2\u9488\u653e\u7f6e\u6216\u63a2\u9488\u5468\u56f4\u7ec4\u7ec7\u53d8\u5316\u800c\u4ea7\u751f\u6d4b\u91cf\u8bef\u5dee\u7684\u53ef\u80fd\u6027\u3002\u7136\u800c\uff0cTDF\u4ecd\u7136\u662f\u795e\u7ecf\u5371\u91cd\u60a3\u8005CBF\u52a8\u529b\u5b66\u7cbe\u7ec6\u7ba1\u7406\u7684\u5b9d\u8d35\u5de5\u5177\u3002<\/p>\n

CMD<\/p>\n

CMD\u662f\u4e00\u79cd\u590d\u6742\u7684\u795e\u7ecf\u76d1\u6d4b\u6280\u672f\uff0c\u8d8a\u6765\u8d8a\u591a\u5730\u7528\u4e8e\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\uff0c\u4ee5\u5728\u7ec6\u80de\u6c34\u5e73\u4e0a\u8bc4\u4f30\u8111\u7ec4\u7ec7\u7684\u4ee3\u8c22\u72b6\u6001\u3002\u8fd9\u9879\u6280\u672f\u5305\u62ec\u5c06\u4e00\u6839\u5c0f\u5bfc\u7ba1\u63d2\u5165\u5927\u8111\u5b9e\u8d28\uff0c\u901a\u5e38\u4f4d\u4e8e\u5927\u8111\u76ae\u5c42\u3002\u8be5\u5bfc\u7ba1\u704c\u6ce8\u6709\u751f\u7406\u6eb6\u6db2\uff0c\u53ef\u4ee5\u6536\u96c6\u7ec6\u80de\u5916\u6db2\u4f53\uff0c\u8fd9\u53cd\u6620\u4e86\u8111\u7ec4\u7ec7\u5185\u53d1\u751f\u7684\u4ee3\u8c22\u8fc7\u7a0b\u3002CMD\u7684\u4e3b\u8981\u9002\u5e94\u75c7\u662fTBI\u3001SAH\u6216\u5927\u534a\u7403\u5352\u4e2d\u60a3\u8005\uff0c\u5b83\u6709\u52a9\u4e8e\u68c0\u6d4b\u53ef\u80fd\u5bfc\u81f4\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u7684\u4ee3\u8c22\u7d0a\u4e71\u3002\u5fae\u900f\u6790\u5bfc\u7ba1\u7684\u653e\u7f6e\u901a\u5e38\u7531\u795e\u7ecf\u6210\u50cf\u6216\u624b\u672f\u6307\u5bfc\uff0c\u76ee\u7684\u662f\u5c06\u5176\u5b9a\u4f4d\u5728\u611f\u5174\u8da3\u7684\u533a\u57df\u5185\u6216\u9644\u8fd1\uff0c\u5982\u5352\u4e2d\u671f\u95f4\u7684\u534a\u5f71\u533a\u6216TBI\u7684\u98ce\u9669\u533a\u57df\u3002\u5206\u6790\u6536\u96c6\u7684\u6837\u672c\u4e2d\u7684\u5404\u79cd\u751f\u7269\u5316\u5b66\u6807\u5fd7\u7269\uff0c\u8fd9\u4e9b\u6807\u5fd7\u7269\u63d0\u4f9b\u7ec6\u80de\u4ee3\u8c22\u4fe1\u606f\uff0c\u5982\u8461\u8404\u7cd6\u3001\u4e73\u9178\u3001\u4e19\u916e\u9178\u548c\u8c37\u6c28\u9178\u6c34\u5e73\u3002<\/p>\n

CMD\u7684\u4e00\u4e2a\u5173\u952e\u7ed3\u679c\u6307\u6807\u662f\u4e73\u9178\u76d0\/\u4e19\u916e\u9178\u76d0\u6bd4\u7387\uff08LPR\uff09\u3002\u6b63\u5e38\u7684LPR\u901a\u5e38\u4f4e\u4e8e25\u3002LPR\u5347\u9ad8\u8868\u660e\u538c\u6c27\u4ee3\u8c22\u53d1\u751f\u53d8\u5316\uff0c\u901a\u5e38\u662f\u7531\u4e8e\u7f3a\u8840\u6216\u7f3a\u6c27\uff0c\u5e76\u4e0e\u8111\u635f\u4f24\u60a3\u8005\u7684\u4e0d\u826f\u9884\u540e\u6709\u5173\u3002LPR\u5347\u9ad8\u53ef\u4ee5\u6307\u5bfc\u65e8\u5728\u6539\u5584\u8111\u704c\u6ce8\u548c\u6c27\u5408\u7684\u5e72\u9884\u63aa\u65bd\u3002\u76f8\u53cd\uff0c\u4f4eLPR\u503c\uff0c\u7279\u522b\u662f\u5f53\u4f34\u6709\u4f4e\u8840\u7cd6\u6c34\u5e73\u65f6\uff0c\u53ef\u80fd\u8868\u660e\u9ad8\u8840\u7cd6\u6eb6\u89e3\uff0c\u8fd9\u662f\u635f\u4f24\u540e\u65e9\u671f\u51fa\u73b0\u7684\u4e00\u79cd\u60c5\u51b5\u3002CMD\u63d0\u4f9b\u6709\u5173\u5927\u8111\u751f\u5316\u73af\u5883\u7684\u5b9e\u65f6\u4fe1\u606f\uff0c\u4e3a\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u63d0\u4f9b\u91cf\u8eab\u5b9a\u5236\u7684\u6cbb\u7597\u3002\u8fd9\u9879\u6280\u672f\u7684\u6570\u636e\u6709\u52a9\u4e8e\u6307\u5bfc\u6cbb\u7597\u51b3\u7b56\uff0c\u5982\u4f18\u5316\u8111\u704c\u6ce8\u538b\u529b\u3001\u8c03\u6574\u8461\u8404\u7cd6\u548c\u6c27\u8f93\u9001\u4ee5\u53ca\u51cf\u8f7b\u5174\u594b\u6027\u6bd2\u6027\u3002\u5c3d\u7ba1CMD\u5177\u6709\u4fb5\u5165\u6027\uff0c\u9700\u8981\u4e13\u95e8\u7684\u8bbe\u5907\u548c\u4e13\u4e1a\u77e5\u8bc6\uff0c\u4f46\u5b83\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u5e93\u4e2d\u7684\u4e00\u4e2a\u5f3a\u5927\u5de5\u5177\uff0c\u4e3a\u5927\u8111\u4ee3\u8c22\u63d0\u4f9b\u4e86\u72ec\u7279\u7684\u89c1\u89e3\uff0c\u5e76\u6307\u5bfc\u60a3\u8005\u7684\u7279\u5b9a\u6cbb\u7597\u7b56\u7565\uff08\u88681\uff09\u3002<\/p>\n

\u9006\u5411\u900f\u6790\u662fCMD\u7684\u4e00\u79cd\u72ec\u7279\u5e94\u7528\uff0c\u901a\u8fc7\u5fae\u900f\u6790\u5bfc\u7ba1\u5c06\u7269\u8d28\u7ed9\u4e88\u8111\u5b9e\u8d28\uff0c\u4ece\u800c\u8fdb\u884c\u5c40\u90e8\u6cbb\u7597\u5e72\u9884\u6216\u4ee3\u8c22\u7814\u7a76\u3002\u9006\u5411\u900f\u6790\u7684\u4e00\u4e2a\u5177\u4f53\u5e94\u7528\u662f\u7425\u73c0\u9178\u7684\u5c40\u7076\u6027\u704c\u6ce8\uff0c\u7425\u73c0\u9178\u662f\u4e09\u7fa7\u9178\u5faa\u73af\u4e2d\u7684\u5173\u952e\u4e2d\u95f4\u4f53\u3002\u901a\u8fc7\u9006\u5411\u900f\u6790\u7ed9\u4e88\u7425\u73c0\u9178\u53ef\u4ee5\u4f5c\u4e3a\u8bc4\u4f30\u8111\u5185\u7ebf\u7c92\u4f53\u529f\u80fd\u548c\u7ec6\u80de\u4ee3\u8c22\u7684\u5de5\u5177\u3002\u8fd9\u79cd\u65b9\u6cd5\u7684\u524d\u63d0\u662f\u5c40\u90e8\u7ed9\u4e88\u7425\u73c0\u9178\u53ef\u4ee5\u6539\u5584\u7ebf\u7c92\u4f53\u547c\u5438\uff0c\u7279\u522b\u662f\u5728\u4ee3\u8c22\u53d7\u635f\u6216\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u7684\u533a\u57df\u3002Stovell\u7b49\u4eba\u65e8\u5728\u7814\u7a76\u7425\u73c0\u9178\u76d0\u5bf9\u6025\u6027\u8111\u5916\u4f24\u60a3\u8005\u5927\u8111\u80fd\u91cf\u4ee3\u8c22\u7684\u5f71\u54cd\u3002\u5bf98\u540d\u8111\u5916\u4f24\u60a3\u8005\u8fdb\u884c\u7684\u7814\u7a76\u8868\u660e\uff0c\u901a\u8fc7\u5fae\u900f\u6790\u704c\u6ce8\u7425\u73c0\u9178\u76d0\u53ef\u63d0\u9ad8\u7ec6\u80de\u5916\u4e19\u916e\u9178\u6c34\u5e73\u5e76\u964d\u4f4eLPR\uff0c\u8868\u660e\u7ec6\u80de\u5316\u5b66\u6027\u8d28\u5f97\u5230\u6539\u5584\u3002\u6709\u8da3\u7684\u662f\uff0c\u5728\u4e2a\u4f53\u60a3\u8005\u4e2d\u53d1\u73b0LPR\u7684\u964d\u4f4e\u4e0e\u78f7\u9178\u808c\u9178\/ATP\u6bd4\u7387\u7684\u589e\u52a0\u4e4b\u95f4\u5b58\u5728\u663e\u8457\u76f8\u5173\u6027\uff0c\u8fd9\u8868\u660e\u7425\u73c0\u9178\u76d0\u53ef\u80fd\u4f1a\u589e\u5f3a\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u7684TBI\u60a3\u8005\u7684\u5927\u8111\u80fd\u91cf\u4ee3\u8c22\u3002\u672c\u7814\u7a76\u652f\u6301LPR\u4e0e\u8111\u80fd\u91cf\u72b6\u6001\u4e4b\u95f4\u7684\u8054\u7cfb\u4ee5\u53ca\u7425\u73c0\u9178\u76d0\u6cbb\u7597TBI\u60a3\u8005\u7684\u6f5c\u529b\u3002<\/p>\n

Khellaf\u7b49\u4eba\u7684\u8fd9\u9879\u7814\u7a76\u96c6\u4e2d\u5728\u8868\u73b0\u51fa\u80fd\u91cf\u4ee3\u8c22\u53d7\u635f\u7684TBI\u60a3\u8005\u8eab\u4e0a\uff0c\u5982LPR\u5347\u9ad8\u6240\u793a\uff0c\u572833\u540dMMM\u4e0bTBI\u60a3\u8005\u4e2d\uff0c73%\u7684\u60a3\u8005\u88ab\u53d1\u73b0\u3002\u7814\u7a76\u4eba\u5458\u901a\u8fc7\u9006\u5411\u900f\u6790\u7ed9\u836f2,3-13C2\u7425\u73c0\u9178\u4e8c\u94a0\uff0c\u89c2\u5bdf\u5230LPR\u964d\u4f4e\u4e8612%\uff0c\u8111\u8461\u8404\u7cd6\u589e\u52a0\u4e8617%\u3002\u5fae\u6e17\u6790\u7269\u7684\u6838\u78c1\u5171\u632f\u6ce2\u8c31\u8bc1\u5b9e\uff0c\u7ed9\u836f\u7684\u7425\u73c0\u9178\u901a\u8fc7\u4e09\u7fa7\u9178\u5faa\u73af\u5728\u7ec6\u80de\u5185\u4ee3\u8c22\u3002\u8fd9\u9879\u7814\u7a76\u4f7f\u7528\u4e86\u4e00\u79cd\u4ee5LPR\u4e3a\u91cd\u70b9\u7684\u5206\u7ea7\u7ba1\u7406\u65b9\u6848\uff0c\u5e76\u6574\u5408\u4e86\u5404\u79cd\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u76d1\u6d4b\u65b9\u6cd5\uff0c\u8bc1\u660e\u7425\u73c0\u9178\u916f\u7ed9\u836f\u53ef\u4ee5\u6539\u5584\u4f34\u6709CMD\u7684TBI\u60a3\u8005\u7684\u80fd\u91cf\u4ee3\u8c22\u3002<\/p>\n

\u76ae\u5c42\u7535\u56fe\u548cdEEG<\/p>\n

\u5728\u91cd\u75c7\u76d1\u62a4\u5ba4\u7684\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\uff0c\u76ae\u5c42\u7535\u56fe\uff08ECoG\uff09\u548cdEEG\u5728\u5168\u9762\u76d1\u6d4b\u548c\u6cbb\u7597\u4e25\u91cd\u8111\u635f\u4f24\u60a3\u8005\u548c\u6709\u795e\u7ecf\u5e76\u53d1\u75c7\u98ce\u9669\u7684\u60a3\u8005\uff08\u5982\u766b\u75eb\u53d1\u4f5c\u6216\u766b\u75eb\uff09\u65b9\u9762\u53d1\u6325\u7740\u5173\u952e\u4f5c\u7528\u3002ICU\u73af\u5883\u4e2d\u7684ECoG\u4e3b\u8981\u7528\u4e8e\u5bf9\u76ae\u5c42\u7535\u6d3b\u52a8\u8fdb\u884c\u7cbe\u786e\u76d1\u6d4b\u81f3\u5173\u91cd\u8981\u7684\u60c5\u51b5\uff0c\u5982TBI\u60a3\u8005\u6216\u795e\u7ecf\u5916\u79d1\u624b\u672f\u540e\u3002\u8fd9\u9879\u6280\u672f\u5305\u62ec\u5c06\u7535\u6781\u76f4\u63a5\u653e\u7f6e\u5728\u5927\u8111\u8868\u9762\uff0c\u63d0\u4f9b\u76ae\u5c42\u7535\u6d3b\u52a8\u7684\u9ad8\u5206\u8fa8\u7387\u6570\u636e\u3002\u5728\u6025\u6027\u62a4\u7406\u73af\u5883\u4e2d\uff0cECoG\u53ef\u4ee5\u7528\u4e8e\u68c0\u6d4b\u5934\u76ae\u8111\u7535\u56fe\u4e0a\u4e0d\u660e\u663e\u7684\u7ec6\u5fae\u766b\u75eb\u53d1\u4f5c\uff0c\u4ece\u800c\u6307\u5bfc\u6297\u766b\u75eb\u6cbb\u7597\u3002\u6b64\u5916\uff0c\u5b83\u53ef\u4ee5\u5b9e\u65f6\u76d1\u6d4b\u76ae\u5c42\u529f\u80fd\uff0c\u4e3a\u8111\u6c34\u80bf\u6216\u8111\u7f3a\u8840\u7684\u51b3\u7b56\u63d0\u4f9b\u6709\u4ef7\u503c\u7684\u4fe1\u606f\u3002<\/p>\n

dEEG\u6d89\u53ca\u5c06\u7535\u6781\u63d2\u5165\u8111\u7ec4\u7ec7\uff0c\u5bf9\u4e8e\u76d1\u6d4b\u8111\u6df1\u90e8\u635f\u4f24\u60a3\u8005\u6216\u63a5\u53d7\u8fc7\u76ae\u8d28\u4e0b\u7ed3\u6784\u624b\u672f\u7684\u60a3\u8005\u81f3\u5173\u91cd\u8981\u3002\u5728\u91cd\u75c7\u76d1\u62a4\u5ba4\uff0cdEEG\u901a\u5e38\u7528\u4e8e\u6709\u766b\u75eb\u53d1\u4f5c\u98ce\u9669\u7684\u60a3\u8005\uff0c\u8fd9\u4e9b\u766b\u75eb\u53d1\u4f5c\u6e90\u4e8e\u5927\u8111\u6df1\u90e8\u533a\u57df\uff0c\u800c\u8868\u9762EEG\u4e0d\u5bb9\u6613\u6355\u6349\u5230\u8fd9\u4e9b\u533a\u57df\u3002\u8fd9\u9879\u6280\u672f\u5728\u533a\u5206\u766b\u75eb\u6d3b\u52a8\u548c\u5176\u4ed6\u5f62\u5f0f\u7684\u5f02\u5e38\u5927\u8111\u6d3b\u52a8\uff08\u5982\u521b\u4f24\u540e\u6216\u672f\u540e\u53d8\u5316\uff09\u65b9\u9762\u7279\u522b\u6709\u4ef7\u503c\u3002dEEG\u63d0\u4f9b\u7684\u766b\u75eb\u53d1\u4f5c\u7684\u7cbe\u786e\u4f4d\u7f6e\u5bf9\u4e8e\u6307\u5bfc\u9776\u5411\u6297\u766b\u75eb\u836f\u7269\u7684\u7ed9\u836f\u4ee5\u53ca\u5728\u96be\u6cbb\u6027\u766b\u75eb\u75c5\u4f8b\u4e2d\u51b3\u5b9a\u6f5c\u5728\u7684\u624b\u672f\u5e72\u9884\u81f3\u5173\u91cd\u8981\u3002<\/p>\n

Connolly\u7b49\u540c\u65f6\u83b7\u5f97\u4e862\u540d\u63a5\u53d7\u4e34\u5e8a\u7206\u53d1\u6291\u5236\u7684\u60a3\u8005\u7684\u8111\u7535\u56fe\u548cICP\u6570\u636e\u3002\u4ed6\u4eec\u786e\u5b9a\u4e86\u4e00\u79cd\u8840\u7ba1\u8212\u5f20\u6307\u6570\u6765\u8bc4\u4f30\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u7684\u795e\u7ecf\u8840\u7ba1\u8026\u8054\u3002\u4ed6\u4eec\u53d1\u73b0\uff0c\u8111\u7535\u56fe\u6355\u6349\u5230\u7684\u7535\u6d3b\u52a8\u4e0eICP\u7684\u77ac\u65f6\u589e\u52a0\u6709\u5173\uff0cICP\u7684\u4e0a\u5347\u548c\u4e0b\u964d\u4e0e\u8111\u7535\u56fe\u4e0a\u770b\u5230\u7684\u7206\u53d1\u548c\u6291\u5236\u6709\u5173\u3002\u4ed6\u4eec\u4f30\u8ba1\u4e86\u4e00\u79cd\u629b\u7269\u7ebf\u5173\u7cfb\uff0c\u5176\u4e2dICP\u5728EEG\u7206\u53d1\u540e8\u79d2\u8fbe\u5230\u5cf0\u503c\uff0c\u7136\u540e\u5728\u5927\u7ea615\u79d2\u540e\u5f52\u4e00\u5316\u3002\u6b64\u5916\uff0c\u76f8\u5173\u8840\u7ba1\u8212\u5f20\u6307\u6570\u7684\u5b58\u5728\u8868\u660e\uff0cICP\u7684\u589e\u52a0\u4e3b\u8981\u662f\u7531\u8111\u8840\u7ba1\u8840\u6d41\u52a8\u529b\u5b66\u7684\u53d8\u5316\u9a71\u52a8\u7684\u3002<\/p>\n

\u4e94<\/p>\n

\u65e0\u521b\u795e\u7ecf\u76d1\u6d4b\u5de5\u5177<\/p>\n

TCD<\/p>\n

TCD\u7684\u4e00\u4e2a\u5173\u952e\u5e94\u7528\u662f\u8ba1\u7b97Lindegaard\u6bd4\u7387\uff0c\u8fd9\u662f\u4e00\u4e2a\u7528\u4e8e\u533a\u5206\u8111\u8840\u7ba1\u75c9\u631b\u548c\u5145\u8840\u7684\u6307\u6807\u3002\u901a\u8fc7\u5c06\u5927\u8111\u4e2d\u52a8\u8109\u7684\u5e73\u5747\u8840\u6d41\u901f\u5ea6\u9664\u4ee5\u9885\u5916\u9888\u5185\u52a8\u8109\u7684\u5e73\u5747\u901f\u5ea6\uff08MV\uff09\u6765\u8ba1\u7b97Lindegaard\u6bd4\u7387\u3002\u6bd4\u503c\u5927\u4e8e3\u8868\u793a\u8840\u7ba1\u75c9\u631b\u3002\u8fd9\u79cd\u533a\u522b\u81f3\u5173\u91cd\u8981\uff0c\u5c24\u5176\u662f\u5728SAH\u540e\u7684\u60a3\u8005\u4e2d\uff0c\u56e0\u4e3a\u5b83\u6307\u5bfc\u6cbb\u7597\u51b3\u7b56\u548c\u5e72\u9884\u63aa\u65bd\uff0c\u4ee5\u63a7\u5236\u8840\u7ba1\u75c9\u631b\u548c\u9884\u9632\u7f3a\u8840\u6027\u5e76\u53d1\u75c7\u3002<\/p>\n

TCD \u8fd8\u53ef\u4ee5\u95f4\u63a5\u4f30\u8ba1 CBF\u3002\u867d\u7136 TCD \u4e0d\u80fd\u76f4\u63a5\u6d4b\u91cf CBF \u5bb9\u91cf\uff0c\u4f46\u8840\u6d41\u901f\u5ea6\u53ef\u4f5c\u4e3a\u66ff\u4ee3\u6307\u6807\u3002\u901a\u8fc7\u8bc4\u4f30\u8840\u6d41\u901f\u5ea6\u5728\u5404\u79cd\u751f\u7406\u548c\u836f\u7269\u6311\u6218\u4e0b\u7684\u53d8\u5316\uff0cTCD \u53ef\u4ee5\u63d0\u4f9b\u6709\u5173\u8111\u8840\u7ba1\u53cd\u5e94\u6027\u548c\u81ea\u52a8\u8c03\u8282\u7684\u4fe1\u606f\u3002\u4f8b\u5982\uff0c\u5c4f\u6c14\u6216\u4e8c\u6c27\u5316\u78b3\u6311\u6218\u6d4b\u8bd5\u7b49\u6280\u672f\u53ef\u7528\u4e8e\u8bc4\u4f30\u8111\u8840\u7ba1\u53cd\u5e94\u6027\uff0c\u4e8c\u6c27\u5316\u78b3\u6c34\u5e73\u7684\u589e\u52a0\u4f1a\u5bfc\u81f4\u8840\u7ba1\u6269\u5f20\u548c\u8840\u6d41\u901f\u5ea6\u589e\u52a0\u3002\u8fd9\u79cd\u53cd\u5e94\u53ef\u4ee5\u91cf\u5316\uff0c\u5e76\u7528\u4e8e\u8bc4\u4f30\u5927\u8111\u81ea\u52a8\u8c03\u8282\u673a\u5236\u7684\u5b8c\u6574\u6027\u3002<\/p>\n

\u4ece TCD \u8d85\u58f0\u6ce2\u4e2d\u83b7\u5f97\u7684\u640f\u52a8\u6307\u6570\uff08PI\uff09\u662f\u53cd\u6620\u8111\u8840\u7ba1\u8840\u6d41\u963b\u529b\u7684\u91cd\u8981\u53c2\u6570\u3002\u640f\u52a8\u6307\u6570\u7684\u8ba1\u7b97\u516c\u5f0f\u4e3a PI = [\u6536\u7f29\u5cf0\u503c\u901f\u5ea6 – \u8212\u5f20\u672b\u671f\u901f\u5ea6 (EDV)]\/MV\u3002\u8d1d\u6797\u683c PI \u516c\u5f0f\u662f\u8868\u793a\u8111\u8840\u7ba1\u963b\u529b\u7684\u53e6\u4e00\u79cd\u65b9\u6cd5\uff0c\u8ba1\u7b97\u516c\u5f0f\u5982\u4e0b\uff1a\u8d1d\u6797\u683c PI = [2 \u00d7 (MV – EDV)]\/\uff08\u6536\u7f29\u901f\u5ea6\u5cf0\u503c + EDV\uff09\u3002\u8fd9\u4e24\u4e2a\u516c\u5f0f\u90fd\u7528\u4e8e\u8bc4\u4f30\u8111\u8840\u6d41\u52a8\u529b\u5b66\uff0cPI \u503c\u8d8a\u9ad8\u901a\u5e38\u8868\u793a\u8111\u8840\u7ba1\u963b\u529b\u8d8a\u5927\uff0c\u8fd9\u5728\u8111\u8840\u7ba1\u75c9\u631b\u6216 ICP \u589e\u9ad8\u7b49\u60c5\u51b5\u4e0b\u53ef\u4ee5\u770b\u5230\u3002<\/p>\n

\u5728 SAH \u60a3\u8005\u4e2d\uff0cPI \u503c\u5347\u9ad8\u901a\u5e38\u8868\u660e\u8111\u8840\u7ba1\u963b\u529b\u589e\u52a0\uff0c\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u8111\u8840\u7ba1\u75c9\u631b\u6216 ICP \u5347\u9ad8\u7b49\u56e0\u7d20\u9020\u6210\u7684\u3002\u76d1\u6d4b SAH \u60a3\u8005\u7684 PI \u7279\u522b\u6709\u52a9\u4e8e\u65e9\u671f\u53d1\u73b0\u8840\u7ba1\u75c9\u631b\uff0c\u8fd9\u662f\u4e00\u79cd\u5e38\u89c1\u7684\u4e25\u91cd\u5e76\u53d1\u75c7\uff0c\u53ef\u5bfc\u81f4\u5ef6\u8fdf\u6027\u8111\u7f3a\u8840\u3002PI \u5347\u9ad8\u53ef\u80fd\u65e9\u4e8e\u8840\u7ba1\u75c9\u631b\u7684\u4e34\u5e8a\u75c7\u72b6\uff0c\u4e3a\u65e9\u671f\u5e72\u9884\u63d0\u4f9b\u4e86\u7a97\u53e3\u3002\u6b64\u5916\uff0cPI \u8fd8\u6709\u52a9\u4e8e\u8bc4\u4f30\u65e8\u5728\u7f13\u89e3\u8840\u7ba1\u75c9\u631b\u548c\u63a7\u5236\u8111\u8840\u6d41\u52a8\u529b\u5b66\u7684\u6cbb\u7597\u5e72\u9884\u63aa\u65bd\u7684\u7597\u6548\u3002PI \u5347\u9ad8\u7ea6 1.5 \u4e0e SAH \u4e2d\u7684\u8840\u7ba1\u75c9\u631b\u6709\u5173\uff0c\u6b63\u5e38 PI \u8303\u56f4\u4e3a 0.5-0.6\u3002<\/p>\n

\u8111\u704c\u6ce8\u538b\u4e5f\u53ef\u6839\u636e TCD \u6d4b\u91cf\u503c\u6309\u4ee5\u4e0b\u516c\u5f0f\u4f30\u7b97\uff1aCPP = \u5e73\u5747\u6d41\u901f\/\uff08\u5e73\u5747\u6d41\u901f – EDV\uff09\u00d7\uff08MAP – \u8212\u5f20\u538b\uff09\u3002<\/p>\n

Kim\u7b49\u4eba\u4ece\u6570\u5343\u4e2a\u5355\u72ec\u7684\u6ce2\u5f62\u4e2d\u521b\u5efa\u4e86\u5e73\u5747ICPwf\u3002\u5728ICU\u7684\u975e\u6025\u6027\u8111\u635f\u4f24\u4e2d\u4e5f\u89c2\u5bdf\u5230\u7c7b\u4f3c\u7684\u8111\u8840\u6d41\u52a8\u529b\u5b66\u635f\u4f24\u3002\u4f8b\u5982\uff0c\u8113\u6bd2\u75c7\u60a3\u8005\u5728\u65e9\u671f\u8113\u6bd2\u75c7\u4e2d\u7684\u4e2d\u4f4d\u8840\u6d41\u901f\u5ea6\u548cPI\u5347\u9ad8\uff0c\u800c\u5728\u65e9\u671f\u8113\u6bd2\u8840\u75c7\u4e2d\u5927\u8111\u81ea\u52a8\u8c03\u8282\u6ca1\u6709\u53d7\u635f\u3002\u7136\u800c\uff0c\u5728\u665a\u671f\u8113\u6bd2\u75c7\u4e2d\uff0c\u5df2\u7ecf\u89c2\u5bdf\u5230\u5927\u8111\u81ea\u52a8\u8c03\u8282\u53d7\u635f\u3002<\/p>\n

NIRS\u4e0e\u8111\u6c27\u9971\u548c\u5ea6\u6d4b\u91cf<\/p>\n

NIRS\u5229\u7528\u7535\u78c1\u6ce2\u8c31\u7684\u8fd1\u7ea2\u5916\u533a\u57df\uff08\u7ea6 500-800 \u7eb3\u7c73\uff09\u6765\u786e\u5b9a\u5927\u8111\u7684\u7279\u6027\u3002\u7ea2\u5916\u7ebf\u5149\u675f\u7a7f\u8fc7\u7269\u8d28\uff0c\u7136\u540e\u7531\u611f\u6d4b\u63a2\u5934\u6839\u636e\u6bd4\u5c14-\u6717\u4f2f\u5b9a\u5f8b\u8fdb\u884c\u89e3\u8bfb\u3002A = [(log)_10 I_0]\/I_i = alc. \u5176\u4e2d A = \u5438\u5149\u5ea6\uff0ca = \u6469\u5c14\u5438\u6536\u7387\uff0cI = \u6837\u54c1\u7684\u8def\u5f84\u957f\u5ea6\uff0cc = \u6eb6\u6db2\u4e2d\u5316\u5408\u7269\u7684\u6d53\u5ea6\u3002<\/p>\n

NIRS\u7684\u4e3b\u8981\u4f18\u70b9\u662f\u65e0\u521b\u3001\u6613\u4e8e\u4f7f\u7528\uff0c\u800c\u4e14\u65e0\u9700\u60a3\u8005\u9547\u9759\u6216\u8f6c\u8fd0\u5373\u53ef\u8fdb\u884c\u5b9e\u65f6\u76d1\u6d4b\u3002\u7136\u800c\uff0c\u5176\u5c40\u9650\u6027\u5305\u62ec\u5bf9\u9885\u5916\u6c61\u67d3\uff08\u5982\u5934\u76ae\u548c\u9885\u9aa8\u8840\u6d41\uff09\u7684\u654f\u611f\u6027\u3001\u6709\u9650\u7684\u7a7f\u900f\u6df1\u5ea6\uff08\u9650\u5236\u4e86\u5bf9\u76ae\u8d28\u8868\u9762\u7684\u8bc4\u4f30\uff09\u4ee5\u53ca\u57fa\u4e8e\u4e2a\u4f53\u89e3\u5256\u548c\u63a2\u9488\u4f4d\u7f6e\u7684\u8bfb\u6570\u53d8\u5316\u3002\u8fd1\u7ea2\u5916\u6210\u50cf\u6280\u672f\u7684\u4e00\u4e2a\u91cd\u8981\u5e94\u7528\u662f\u8bc4\u4f30\u5927\u8111\u7684\u81ea\u52a8\u8c03\u8282\u80fd\u529b\uff0c\u4ee5\u53ca\u5927\u8111\u5728\u5168\u8eab\u8840\u538b\u53d8\u5316\u7684\u60c5\u51b5\u4e0b\u4fdd\u6301\u7a33\u5b9a CBF \u7684\u80fd\u529b\u3002\u8fd1\u7ea2\u5916\u5149\u8c31\u53ef\u751f\u6210\u5404\u79cd\u6d4b\u91cf\u503c\uff0c\u5305\u62ec\u533a\u57df\u8111\u6c27\u9971\u548c\u5ea6\uff08rSO2\uff09\u3001\u533a\u57df\u8111\u8840\u6d41\u6307\u6570\u3001\u7ec4\u7ec7\u6c27\u6444\u53d6\u5206\u6570\u3001\u7ec4\u7ec7\u6c27\u5408\u6307\u6570\u548c\u76f8\u5bf9\u603b\u7ec4\u7ec7\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\u3002\u8fd8\u53ef\u4ee5\u901a\u8fc7\u6d4b\u91cf\u7ec6\u80de\u8272\u7d20 c \u6c27\u5316\u9176\u7684\u6c27\u5316\u72b6\u6001\u6765\u4f30\u8ba1\u795e\u7ecf\u5143\u5185\u7684\u6c27\u4ee3\u8c22\u3002<\/p>\n

\u65f6\u57df\u548c\u9891\u57df\u5206\u6790\u5bf9\u4e8e\u8bc4\u4f30\u5927\u8111\u81ea\u8c03\u8282\u548c\u8840\u6d41\u52a8\u6001\u81f3\u5173\u91cd\u8981\u3002\u6839\u636e rSO2 \u4e0e ABP \u7684\u76f8\u5173\u6027\u5f97\u51fa\u7684\u8111\u6c27\u9971\u548c\u5ea6\u6307\u6570\uff08COx\uff09\u5229\u7528\u65f6\u57df\u5206\u6790\u89c2\u5bdf rSO2 \u5982\u4f55\u968f\u8840\u538b\u6ce2\u52a8\u800c\u53d8\u5316\uff0c\u5e76\u5229\u7528\u9891\u57df\u5206\u6790\u68c0\u67e5\u8fd9\u4e9b\u4fe1\u53f7\u7684\u9891\u8c31\u6210\u5206\u3002COx \u9633\u6027\u8868\u660e\u81ea\u8c03\u8282\u529f\u80fd\u53d7\u635f\uff0c\u5373\u8111\u6c27\u88ab\u52a8\u8ddf\u968f\u7cfb\u7edf\u538b\u529b\u7684\u53d8\u5316\u3002\u7ec4\u7ec7\u6c27\u53cd\u5e94\u6307\u6570\uff08TOx\uff09\u4e0e ABP \u76f8\u5173\uff0c\u5176\u529f\u80fd\u7c7b\u4f3c\uff0c\u53ef\u63d0\u4f9b\u6709\u5173\u8111\u6c27\u5408\u7a33\u5b9a\u6027\u7684\u4fe1\u606f\u3002\u8840\u7ea2\u86cb\u767d\u5bb9\u79ef\u6307\u6570\uff08HVx\uff09\u4f7f\u7528\u8fd1\u7ea2\u5916\u5149\u8c31\u7684\u76f8\u5bf9\u603b\u7ec4\u7ec7\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\uff0c\u5e76\u5c06\u5176\u4e0e ABP \u76f8\u5173\u8054\uff0c\u4ee5\u8bc4\u4f30\u8111\u8840\u5bb9\u91cf\u7684\u53d8\u5316\u3002HVx \u5448\u9633\u6027\u8868\u660e\u81ea\u8c03\u8282\u529f\u80fd\u53d7\u635f\uff0c\u8868\u73b0\u4e3a\u8111\u8840\u5bb9\u91cf\u4e0e\u8840\u538b\u4e4b\u95f4\u7684\u88ab\u52a8\u5173\u7cfb\u3002<\/p>\n

\u6700\u540e\uff0c\u8111\u8840\u6d41\u81ea\u52a8\u8c03\u8282\u6307\u6570\u5c06\u533a\u57df\u8111\u8840\u6d41\u6307\u6570\u4e0e ABP \u8054\u7cfb\u8d77\u6765\uff0c\u6709\u52a9\u4e8e\u4e86\u89e3NIRS\u4f30\u6d4b\u7684 CBF \u5982\u4f55\u5bf9\u5168\u8eab\u538b\u529b\u53d8\u5316\u505a\u51fa\u53cd\u5e94\u3002\u8111\u8840\u6d41\u81ea\u52a8\u8c03\u8282\u6307\u6570\u7684\u9ad8\u76f8\u5173\u6027\u610f\u5473\u7740\u8840\u538b\u5bf9 CBF \u6709\u76f4\u63a5\u5f71\u54cd\uff0c\u8868\u660e\u4e27\u5931\u4e86\u81ea\u52a8\u8c03\u8282\u80fd\u529b\u3002\u6b63\u5e38\u7684 rSO2 \u503c\u4e3a 55%-80%\uff0c\u4f4e\u4e8e 50%\u5219\u8868\u793a\u8111\u7f3a\u8840\u3002TOx\u548cCOx\u662f\u8bc4\u4f30\u5927\u8111\u81ea\u52a8\u8c03\u8282\u80fd\u529b\u6700\u5e7f\u6cdb\u4f7f\u7528\u7684\u6307\u6807\u3002TOx\/COx \u503c\u5347\u9ad8\u4e0e\u8c35\u5984\u548c\u6b7b\u4ea1\u98ce\u9669\u589e\u52a0\u6709\u5173\u3002\u8fd9\u4e9b\u5206\u6790\u6709\u52a9\u4e8e\u521b\u4f24\u6027\u8111\u635f\u4f24\u3001\u8111\u5352\u4e2d\u548c SAH \u7b49\u75be\u75c5\u7684\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\uff0c\u4e3a\u7279\u5b9a\u60a3\u8005\u7684\u6cbb\u7597\u63d0\u4f9b\u91cd\u8981\u4fe1\u606f\uff08\u8868 2\uff09\u3002<\/p>\n

Damian\u7b49\u4eba\u63a2\u8ba8\u4e86NIRS\u5728\u76d1\u6d4b\u5b8c\u5168\u6027\u5927\u8111\u4e2d\u52a8\u8109\u5352\u4e2d\u548c\u76f8\u5173\u8111\u80bf\u80c0\u60a3\u8005\u9885\u5185\u6c27\u5408\u65b9\u9762\u7684\u6709\u6548\u6027\u3002\u8fd9\u9879\u7814\u7a76\u6d89\u53ca24\u540d\u60a3\u8005\uff0c\u4ed6\u4eec\u5728\u4e24\u4e2a\u989d\u53f6\u4e0a\u653e\u7f6e\u8fd1\u7ea2\u5916\u5149\u7535\u4e8c\u6781\u7ba1\uff0c\u4ee5\u9891\u7e41\u95f4\u9694\u6d4b\u91cfrSO2\u3002\u7814\u7a76\u7ed3\u679c\u8868\u660e\uff0c\u5c3d\u7ba1rSO2\u7684\u7edd\u5bf9\u503c\u5728\u60a3\u8005\u4e4b\u95f4\u5b58\u5728\u663e\u8457\u5dee\u5f02\uff0c\u5e76\u4e14\u4e0e\u4e34\u5e8a\u6570\u636e\u6ca1\u6709\u76f4\u63a5\u76f8\u5173\u6027\uff0c\u4f46\u6897\u6b7b\u534a\u7403\u548c\u5bf9\u4fa7\u534a\u7403\u4e4b\u95f4\u7684rSO2\u5dee\u5f02\u63d0\u4f9b\u4e86\u6709\u4ef7\u503c\u7684\u4fe1\u606f\u3002\u5728\u5927\u591a\u6570\u60c5\u51b5\u4e0b\uff0c\u6897\u6b7b\u4fa7\u7684\u8fd9\u79cd\u5dee\u5f02\u901a\u5e38\u66f4\u9ad8\u3002\u7279\u522b\u662f\uff0crSO2\u7684\u5dee\u5f02\u968f\u7740\u8111\u80bf\u80c0\u800c\u964d\u4f4e\uff0c\u5728\u8111\u759d\u60a3\u8005\u4e2d\u6d88\u5931\uff0c\u4f46\u5728\u6210\u529f\u7684\u534a\u9885\u9aa8\u51cf\u538b\u5207\u9664\u672f\u540e\u663e\u8457\u589e\u52a0\u3002Kurth\u7b49\u4eba\u7684\u7814\u7a76\u91cd\u70b9\u662f\u4f7f\u7528NIRS\u786e\u5b9a\u65b0\u751f\u513f\uff08\u4ed4\u732a\uff09\u8111\u6c27\u9971\u548c\u5ea6\uff08SCO2\uff09\u7684\u7f3a\u6c27\u7f3a\u8840\u6027\u9608\u503c\u3002\u572860\u5934\u9ebb\u9189\u4ed4\u732a\u4e2d\uff0c\u8be5\u7814\u7a76\u5c06SCO2\u6c34\u5e73\u4e0e\u8111\u7535\u56fe\u3001\u8111ATP\u548c\u4e73\u9178\u6d53\u5ea6\u7684\u53d8\u5316\u76f8\u5173\u8054\uff0c\u5e76\u5c06\u5176\u4e0eCBF\u548c\u77e2\u72b6\u7aa6\u6c27\u9971\u548c\u5ea6\u8fdb\u884c\u6bd4\u8f83\u3002\u5173\u952e\u53d1\u73b0\u5305\u62ec\u786e\u5b9a\u4e73\u9178\u589e\u52a0\u3001\u8f7b\u5fae\u548c\u4e3b\u8981\u8111\u7535\u56fe\u53d8\u5316\u4ee5\u53caATP\u51cf\u5c11\u7684SCO2\u9608\u503c\uff0c\u5206\u522b\u4e3a44%\u300142%\u300137%\u548c33%\u3002\u8fd9\u4e9b\u9608\u503c\u660e\u663e\u4f4e\u4e8e68%\u7684\u57fa\u7ebfSCO2\uff0c\u8868\u660e\u5728\u6b63\u5e38\u529f\u80fd\u548c\u529f\u80fd\u969c\u788d\u4e4b\u95f4\u6709\u4e00\u4e2a\u76f8\u5f53\u5927\u7684\u7f13\u51b2\u533a\u3002<\/p>\n

\u5229\u7528NIRS\u7684\u4e00\u4e2a\u4e3b\u8981\u9650\u5236\u56e0\u7d20\u662f\u6563\u5c04\u548c\u53cd\u5c04\u3002\u5149\u675f\u4f1a\u7a7f\u8fc7\u591a\u5c42\u76ae\u80a4\u3001\u7ec4\u7ec7\u548c\u9aa8\u9abc\u3002\u5178\u578b\u7684\u5149\u6e90\u5230\u68c0\u6d4b\u8ddd\u79bb\u4e3a 4 \u5398\u7c73\uff0c\u53ef\u6d4b\u91cf\u7ea6 0.3 \u5398\u7c73\u7684\u5927\u8111\u76ae\u5c42\u3002\u6b64\u5916\uff0c\u5728\u795e\u7ecf\u5916\u79d1\u60a3\u8005\u6216\u60a3\u6709\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u60a3\u8005\u4e2d\uff0cCSF\u3001\u786c\u819c\u4e0b\u79ef\u6db2 \u548c\u8840\u6db2\u5236\u54c1\uff08\u5305\u62ec\u94c1\uff09\u53ef\u80fd\u4f1a\u8fdb\u4e00\u6b65\u5f71\u54cdNIRS\u7684\u4e34\u5e8a\u5e94\u7528\u3002\u60a3\u8005\u4e4b\u95f4\u7684\u751f\u7269\u5b66\u5dee\u5f02\uff0c\u5305\u62ec\u52a8-\u9759\u8109\u5145\u76c8\u7684\u53d8\u5316\uff0c\u4e5f\u59a8\u788d\u4e86 \u201c\u6b63\u5e38 \u201d\u57fa\u7ebf\u503c\u7684\u4f7f\u7528\u3002\u76f8\u53cd\uff0c\u5c06NIRS\u6307\u6570\u4f5c\u4e3a\u53d8\u5316\u7684 \u201c\u8d8b\u52bf\u76d1\u6d4b\u5668 \u201d\u53ef\u80fd\u4f1a\u6709\u66f4\u5927\u7684\u4e34\u5e8a\u7528\u9014\u3002<\/p>\n

ONSD<\/p>\n

\u6d4b\u91cf ONSD \u5df2\u6210\u4e3a\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u4f30\u7b97 ICP \u7684\u4e00\u79cd\u65e0\u521b\u6280\u672f\u3002ONSD \u8bc4\u4f30\u6240\u4f9d\u636e\u7684\u539f\u7406\u662f\uff0c\u89c6\u795e\u7ecf\u9798\u4e0e\u86db\u7f51\u819c\u4e0b\u8154\u76f8\u90bb\uff0c\u80fd\u53cd\u6620 CSF \u538b\u529b\u7684\u53d8\u5316\u3002ICP \u7684\u589e\u52a0\u4f1a\u5bfc\u81f4\u89c6\u795e\u7ecf\u9798\u76f4\u5f84\u7684\u76f8\u5e94\u589e\u52a0\u3002\u89c6\u795e\u7ecf\u9798\u76f4\u5f84\u901a\u5e38\u91c7\u7528\u7ecf\u7736\u8d85\u58f0\u6280\u672f\u8fdb\u884c\u6d4b\u91cf\uff0c\u8fd9\u662f\u4e00\u79cd\u5e8a\u65c1\u8d85\u58f0\u6280\u672f\u3002\u5c06\u8d85\u58f0\u63a2\u5934\u653e\u5728\u95ed\u5408\u7684\u773c\u7751\u4e0a\uff0c\u5728\u89c6\u795e\u7ecf\u5782\u76f4\u4e8e\u63a2\u5934\u7684\u773c\u7403\u540e 3 \u6beb\u7c73\u5904\u8fdb\u884c\u6d4b\u91cf\u3002<\/p>\n

\u5728\u65e0\u6cd5\u8fdb\u884c\u6709\u521b ICP \u76d1\u6d4b\u6216\u6709\u521b\u65b9\u6cd5\u7981\u5fcc\u75c7\u7684\u60a3\u8005\u4e2d\uff0cONSD \u6d4b\u91cf\u5c24\u5176\u6709\u7528\u3002\u5b83\u5df2\u88ab\u6709\u6548\u7528\u4e8e\u6cbb\u7597\u521b\u4f24\u6027\u8111\u635f\u4f24\u3001\u4e2d\u98ce\u548c\u7279\u53d1\u6027\u9885\u5185\u9ad8\u538b\u7b49\u75be\u75c5\u3002\u591a\u9879\u7814\u7a76\u9a8c\u8bc1\u4e86 ONSD \u6d4b\u91cf\u503c\u4e0e\u6709\u521b ICP \u8bfb\u6570\u4e4b\u95f4\u7684\u76f8\u5173\u6027\u3002\u636e\u62a5\u9053\uff0cONSD \u68c0\u6d4b ICP \u5347\u9ad8\u7684\u7075\u654f\u5ea6\u548c\u7279\u5f02\u6027\u90fd\u5f88\u9ad8\uff0c\u662f\u4e00\u79cd\u53ef\u9760\u7684\u66ff\u4ee3\u6807\u8bb0\u7269\u3002\u7136\u800c\uff0c\u60a3\u8005\u4e2a\u4f53\u5dee\u5f02\u548c\u6280\u672f\u4f9d\u8d56\u6027\u662f\u9700\u8981\u4ed4\u7ec6\u89e3\u8bfb ONSD \u6d4b\u91cf\u7ed3\u679c\u7684\u56e0\u7d20\u3002<\/p>\n

Chang \u7b49\u4eba\u63a2\u8ba8\u4e86 TBI \u60a3\u8005\u672f\u540e PI\u3001ONSD \u548c ICP \u4e4b\u95f4\u7684\u76f8\u5173\u6027\u3002\u8be5\u7814\u7a76\u6d89\u53ca 68 \u540d TBI \u60a3\u8005\uff0c\u4f7f\u7528 TCD \u8d85\u58f0\u6ce2\u5206\u6790\u4e86\u8fd9\u4e9b\u53c2\u6570\u4e4b\u95f4\u7684\u5173\u7cfb\u3002\u4e3b\u8981\u53d1\u73b0\u5305\u62ec ONSD \u548c ICP \u4e4b\u95f4\u5b58\u5728\u660e\u663e\u7684\u76f8\u5173\u6027\uff0c\u5c24\u5176\u662f\u5f53 ONSD \u2265 5 mm \u65f6\u3002\u6b64\u5916\uff0c\u8fd8\u89c2\u5bdf\u5230 PI \u4e0e ICP \u4e4b\u95f4\u5b58\u5728\u5f88\u5f3a\u7684\u76f8\u5173\u6027\uff0c\u5c24\u5176\u662f\u5728\u672f\u540e\u7b2c 6 \u5929\u548c\u7b2c 7 \u5929\u3002\u7814\u7a76\u8fd8\u8bc4\u4f30\u4e86 PI \u548c ONSD \u5728\u9884\u6d4b\u9885\u5185\u9ad8\u538b\u65b9\u9762\u7684\u6709\u6548\u6027\uff0c\u53d1\u73b0 PI \u2265 1.2 mm \u548c ONSD < 5 mm \u7684\u7ec4\u5408\u63d0\u4f9b\u4e86\u6700\u51c6\u786e\u7684\u9884\u6d4b\uff0c\u66f2\u7ebf\u4e0b\u9762\u79ef (AUC) \u4e3a 0.943\u3002\u8fd9\u4e9b\u7ed3\u679c\u51f8\u663e\u4e86 PI \u548c ONSD \u4f5c\u4e3a\u65e0\u521b\u65b9\u6cd5\u8bc4\u4f30\u548c\u9884\u6d4b TBI \u672f\u540e\u60a3\u8005 ICP \u5347\u9ad8\u7684\u5b9e\u7528\u6027\u3002<\/p>\n

\u5728\u7cfb\u7edf\u56de\u987e\u548c\u835f\u8403\u5206\u6790\u4e2d\uff0cAletreby \u7b49\u4eba\u8bc4\u4f30\u4e86 ONSD \u8d85\u58f0\u6ce2\u4f5c\u4e3a\u5347\u9ad8\u7684 ICP \u975e\u4fb5\u5165\u6027\u4f30\u7b97\u6307\u6807\u7684\u8bca\u65ad\u51c6\u786e\u6027\uff0c\u5e76\u5c06\u5176\u4e0e\u6807\u51c6\u4fb5\u5165\u6027 ICP \u6d4b\u91cf\u8fdb\u884c\u4e86\u6bd4\u8f83\u3002\u56de\u987e\u6027\u7814\u7a76\u5305\u62ec 18 \u9879\u524d\u77bb\u6027\u7814\u7a76\uff0c\u4e3b\u8981\u5206\u6790\u4e86 16 \u9879\u7814\u7a76\u4e2d\u7684 619 \u540d\u60a3\u8005\u3002\u5206\u6790\u7279\u522b\u663e\u793a\uff0cICP \u548c ONSD \u4e4b\u95f4\u7684\u76f8\u5173\u7cfb\u6570\u4e3a 0.7\uff0c\u8868\u660e\u4e24\u8005\u5173\u7cfb\u5bc6\u5207\u3002\u7136\u800c\uff0c\u5143\u56de\u5f52\u5e76\u672a\u53d1\u73b0\u4efb\u4f55\u91cd\u8981\u7684\u534f\u53d8\u91cf\uff0c\u5bf9\u4e25\u91cd\u521b\u4f24\u6027\u8111\u635f\u4f24\u548c\u5b9e\u8d28ICP\u8fdb\u884c\u7684\u4e9a\u7ec4\u5206\u6790\u8868\u660e\u6ca1\u6709\u5f02\u8d28\u6027\u3002\u7814\u7a76\u5f97\u51fa\u7684\u7ed3\u8bba\u662f\uff0c\u867d\u7136 ONSD \u8d85\u58f0\u662f\u8bc4\u4f30 ICP \u7684\u91cd\u8981\u5de5\u5177\uff0c\u4f46\u5728\u53ef\u884c\u548c\u9002\u5f53\u7684\u60c5\u51b5\u4e0b\uff0c\u5b83\u4e0d\u5e94\u53d6\u4ee3\u4fb5\u5165\u6027\u65b9\u6cd5\u3002ONSD \u7684\u8bca\u65ad\u7cbe\u786e\u5ea6\u5f88\u9ad8\uff0c\u8fd9\u8868\u660e\u5b83\u53ef\u4f5c\u4e3a\u8bc4\u4f30 ICP \u7684\u8f85\u52a9\u5de5\u5177\uff0c\u5c24\u5176\u662f\u5728\u65e0\u6cd5\u7acb\u5373\u6216\u65e0\u6cd5\u8fdb\u884c\u6709\u521b\u76d1\u6d4b\u7684\u60c5\u51b5\u4e0b\u3002<\/p>\n

TMD<\/p>\n

TMD \u6d4b\u91cf\u662f\u4e00\u79cd\u65b0\u5174\u7684\u4f30\u7b97 ICP \u7684\u65e0\u521b\u6280\u672f\u3002\u5176\u57fa\u672c\u539f\u7406\u57fa\u4e8e\u9885\u5185\u8154\u4e0e\u5185\u8033\u6dcb\u5df4\u5468\u56f4\u6db2\u4e4b\u95f4\u7684\u89e3\u5256\u548c\u751f\u7406\u8054\u7cfb\u3002ICP \u7684\u53d8\u5316\u4f1a\u4f20\u9012\u5230\u8033\u5468\u6db2\uff0c\u5e76\u5f71\u54cd\u9f13\u819c\u7684\u4f4d\u7f6e\u548c\u6d3b\u52a8\u5ea6\u3002TMD \u4f7f\u7528\u4e13\u95e8\u8bbe\u5907\u8fdb\u884c\u6d4b\u91cf\uff0c\u8be5\u8bbe\u5907\u53ef\u68c0\u6d4b\u9f13\u819c\u5728\u58f0\u97f3\u523a\u6fc0\u4e0b\u7684\u8fd0\u52a8\u5e76\u8fdb\u884c\u91cf\u5316\u3002\u901a\u5e38\uff0c\u5c06\u63a2\u9488\u63d2\u5165\u5916\u8033\u9053\uff0c\u5f62\u6210\u5bc6\u5c01\u3002\u5f15\u5165\u4f4e\u9891\u58f0\u6ce2\uff0c\u8bb0\u5f55\u9f13\u819c\u7684\u79fb\u52a8\u3002\u7136\u540e\u5bf9\u4f4d\u79fb\u6a21\u5f0f\u8fdb\u884c\u5206\u6790\uff0c\u4ee5\u63a8\u65ad ICP \u6c34\u5e73\uff0c\u7279\u5b9a\u7684\u4f4d\u79fb\u7279\u5f81\u4e0e ICP \u7684\u589e\u52a0\u76f8\u5173\u3002<\/p>\n

Evensen \u7b49\u4eba\u8fdb\u884c\u4e86\u4e00\u9879\u7814\u7a76\uff0c\u4ee5\u786e\u5b9a\u9f13\u819c\u538b\u529b (TMP) \u6ce2\u5f62\u662f\u5426\u53ef\u4ee5\u65e0\u521b\u4f30\u8ba1 ICP \u6ce2\u5f62\u3002\u8be5\u7814\u7a76\u6d89\u53ca 28 \u540d\u56e0\u4e34\u5e8a\u539f\u56e0\uff08\u5982 SAH \u540e\u7684\u76d1\u6d4b\u6216 CSF \u5faa\u73af\u969c\u788d\u7684\u8bca\u65ad\uff09\u800c\u63a5\u53d7\u6709\u521b ICP \u6d4b\u91cf\u7684\u60a3\u8005\u3002\u7814\u7a76\u4eba\u5458\u4e3a\u6bcf\u4f4d\u53c2\u4e0e\u8005\u5efa\u7acb\u4e86\u6709\u521b ICP \u548c\u65e0\u521b TMP \u4fe1\u53f7\u4e4b\u95f4\u7684\u4f20\u9012\u51fd\u6570\u4f30\u8ba1\u503c\uff0c\u76ee\u7684\u662f\u8bc4\u4f30\u8be5\u65b9\u6cd5\u7684\u6f5c\u529b\u3002\u8be5\u65b9\u6cd5\u7684\u9a8c\u8bc1\u5305\u62ec\u6bd4\u8f83\u6839\u636e\u4f30\u8ba1\u7684 ICPwf \u548c\u6709\u521b\u6d4b\u91cf\u7684 ICPwf \u8ba1\u7b97\u51fa\u7684\u5e73\u5747\u6ce2\u5e45 (MWA)\u3002\u7814\u7a76\u53d1\u73b0\uff0c\u5728 28 \u540d\u60a3\u8005\u4e2d\uff0c\u6709 4 \u540d\u60a3\u8005\uff0814%\uff09\u7684\u7279\u5b9a\u65e0\u521b ICP \u4fe1\u53f7\u53ef\u4ee5\u4ee4\u4eba\u6ee1\u610f\u5730\u9884\u6d4b MWA\u3002\u5728\u8fd9 4 \u540d\u60a3\u8005\u4e2d\uff0c\u8d85\u8fc7 50% \u7684\u89c2\u5bdf\u7ed3\u679c\u663e\u793a\uff0c\u539f\u59cb MWA \u4e0e\u4f30\u8ba1 MWA \u4e4b\u95f4\u7684\u5dee\u5f02\u5c0f\u4e8e 1.0 mmHg\uff0c\u8d85\u8fc7 20% \u7684\u89c2\u5bdf\u7ed3\u679c\u663e\u793a\uff0c\u539f\u59cb MWA \u4e0e\u4f30\u8ba1 MWA \u4e4b\u95f4\u7684\u5dee\u5f02\u5c0f\u4e8e 0.5 mmHg\u3002\u6b64\u5916\uff0c\u7814\u7a76\u8fd8\u53d1\u73b0\u8033\u8717\u5bfc\u6c34\u7ba1\u5177\u6709\u7269\u7406\u4f4e\u901a\u6ee4\u6ce2\u5668\u7684\u529f\u80fd\uff0c\u4f1a\u5f71\u54cd\u538b\u529b\u4fe1\u53f7\u7684\u4f20\u8f93\u3002\u8fd9\u4e00\u53d1\u73b0\u610f\u4e49\u91cd\u5927\uff0c\u56e0\u4e3a\u5b83\u8868\u660e\u4f7f\u7528 TMP \u6ce2\u5f62\u5bf9\u67d0\u4e9b\u60a3\u8005\u7684 ICPwf \u8fdb\u884c\u65e0\u521b\u4f30\u8ba1\u662f\u53ef\u884c\u7684\uff0c\u5c3d\u7ba1\u8fd9\u79cd\u65b9\u6cd5\u7684\u6709\u6548\u6027\u56e0\u4eba\u800c\u5f02\u3002\u7814\u7a76\u8868\u660e TMP \u6ce2\u5f62\u5206\u6790\u5728\u65e0\u521b ICP \u76d1\u6d4b\u4e2d\u7684\u6f5c\u529b\uff0c\u4f46\u4e5f\u5f3a\u8c03\u4e86\u8fdb\u4e00\u6b65\u7814\u7a76\u7684\u5fc5\u8981\u6027\uff0c\u4ee5\u63d0\u9ad8\u5176\u51c6\u786e\u6027\u548c\u9002\u7528\u6027\u3002<\/p>\n

PET<\/p>\n

\u6b63\u7535\u5b50\u53d1\u5c04\u8ba1\u7b97\u673a\u65ad\u5c42\u663e\u50cf\uff08PET\uff09\u662f\u4e00\u79cd\u9ad8\u5ea6\u590d\u6742\u7684\u6210\u50cf\u6a21\u5f0f\uff0c\u901a\u8fc7\u63d0\u4f9b\u5927\u8111\u75c5\u7406\u5b66\u7684\u529f\u80fd\u548c\u4ee3\u8c22\u4fe1\u606f\uff0c\u5728\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u53d1\u6325\u7740\u5173\u952e\u4f5c\u7528\u3002\u6b63\u7535\u5b50\u53d1\u5c04\u8ba1\u7b97\u673a\u65ad\u5c42\u663e\u50cf\uff08PET\uff09\u662f\u901a\u8fc7\u68c0\u6d4b\u6b63\u7535\u5b50\u53d1\u5c04\u653e\u5c04\u6027\u6838\u7d20\uff08\u793a\u8e2a\u5242\uff09\u95f4\u63a5\u53d1\u5c04\u7684\u4f3d\u9a6c\u5c04\u7ebf\u6765\u5b9e\u73b0\u7684\uff0c\u8fd9\u79cd\u653e\u5c04\u6027\u6838\u7d20\u662f\u901a\u8fc7\u751f\u7269\u6d3b\u6027\u5206\u5b50\u8fdb\u5165\u4eba\u4f53\u7684\u3002\u8fd9\u79cd\u6280\u672f\u5bf9\u4e8e\u8bc4\u4f30\u5927\u8111\u65b0\u9648\u4ee3\u8c22\u3001\u8840\u6d41\u91cf\u548c\u53d7\u4f53\u7ed3\u5408\u5c24\u4e3a\u91cd\u8981\uff0c\u662f\u4e86\u89e3\u5927\u8111\u751f\u5316\u8fc7\u7a0b\u7684\u4e00\u4e2a\u72ec\u7279\u7a97\u53e3\u3002\u901a\u5e38\u60c5\u51b5\u4e0b\uff0c\u793a\u8e2a\u5242\uff08\u5982 18F-\u6c1f\u8131\u6c27\u8461\u8404\u7cd6\uff09\u4f1a\u88ab\u6d3b\u8dc3\u7684\u8111\u7ec4\u7ec7\u5438\u6536\u3002PET \u626b\u63cf\u5230\u7684\u793a\u8e2a\u5242\u5206\u5e03\u4e0e\u533a\u57df\u6027\u8111\u8461\u8404\u7cd6\u4ee3\u8c22\u76f8\u5173\uff0c\u53ef\u5e2e\u52a9\u4e86\u89e3\u795e\u7ecf\u5143\u7684\u6d3b\u529b\u548c\u529f\u80fd\u3002\u6b63\u7535\u5b50\u53d1\u5c04\u8ba1\u7b97\u673a\u65ad\u5c42\u663e\u50cf\u7684\u4e3b\u8981\u4f18\u70b9\u662f\u80fd\u591f\u63d0\u4f9b\u6709\u5173\u5927\u8111\u529f\u80fd\u72b6\u6001\u7684\u8be6\u7ec6\u4fe1\u606f\uff0c\u8fd9\u662f\u5176\u4ed6\u6210\u50cf\u6a21\u5f0f\u65e0\u6cd5\u83b7\u5f97\u7684\u3002\u7136\u800c\uff0c\u5176\u5c40\u9650\u6027\u5305\u62ec\u6210\u672c\u9ad8\u3001\u53ef\u7528\u6027\u6709\u9650\u4ee5\u53ca\u9700\u8981\u653e\u5c04\u6027\u793a\u8e2a\u5242\u3002\u6b64\u5916\uff0cPET \u6570\u636e\u7684\u89e3\u8bfb\u9700\u8981\u590d\u6742\u7684\u5206\u6790\u6280\u672f\u548c\u5bf9\u5927\u8111\u75c5\u7406\u751f\u7406\u5b66\u7684\u900f\u5f7b\u7406\u89e3\u3002<\/p>\n

Veenith \u7b49 \u5229\u7528\u6c27 15 \u6807\u8bb0 PET \u548c\u6c1f 18 \u6807\u8bb0\u7684\u6c1f\u54aa\u5511\uff0818F-FMISO\uff09PET \u8054\u5408\u6210\u50cf\u7814\u7a76\u4e86\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u7684\u7ec4\u7ec7\u7f3a\u6c27\u548c\u7f3a\u8840\u60c5\u51b5\u3002\u8fd9\u9879\u7814\u7a76\u6d89\u53ca 10 \u540d\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u548c\u4e24\u4e2a\u5bf9\u7167\u7ec4\uff0c\u6bcf\u4e2a\u5bf9\u7167\u7ec4\u6709 10 \u540d\u5065\u5eb7\u5fd7\u613f\u8005\uff0c\u4ed6\u4eec\u90fd\u63a5\u53d7\u4e86 18F-FMISO \u548c\u6c27 15 \u6807\u8bb0\u7684 PET \u626b\u63cf\u3002\u7814\u7a76\u8bc4\u4f30\u4e86\u521b\u4f24\u6027\u8111\u635f\u4f24\u65e9\u671f\u5927\u8840\u7ba1\u548c\u5fae\u8840\u7ba1\u7f3a\u8840\u7684\u8d1f\u62c5\u548c\u5206\u5e03\u60c5\u51b5\u3002\u4e3b\u8981\u53d1\u73b0\u662f\uff0c\u4e0e\u5bf9\u7167\u7ec4\u76f8\u6bd4\uff0c\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u7f3a\u8840\u8111\u5bb9\u91cf\u548c\u7f3a\u6c27\u8111\u5bb9\u91cf\u7684\u4e2d\u4f4d\u6570\u660e\u663e\u66f4\u9ad8\u3002\u8fd9\u4e9b\u75c5\u7406\u751f\u7406\u5b66\u7ec4\u7ec7\u7c7b\u522b\u5728\u635f\u4f24\u8111\u533a\u548c\u6b63\u5e38\u5916\u89c2\u8111\u533a\u7684\u7a7a\u95f4\u5206\u5e03\u4e0d\u5339\u914d\u3002\u7f3a\u6c27\u8111\u5bb9\u91cf\u533a\u7684 CBF\u3001\u8111\u8840\u5bb9\u91cf\u548c\u8111\u6c27\u4ee3\u8c22\u7387\u4e0e\u7f3a\u8840\u8111\u5bb9\u91cf\u533a\u76f8\u4f3c\uff0c\u4f46\u6c27\u6444\u53d6\u5206\u6570\u8f83\u4f4e\uff0c\u8868\u660e\u635f\u4f24\u66f4\u4e3a\u4e25\u91cd\u3002\u5bf9\u8111\u7ec4\u7ec7\u8840\u6c27\u9971\u548c\u5ea6\u7684\u76d1\u6d4b\u8868\u660e\uff0c\u5728\u6c27\u5206\u538b\u4e3a 15 mmHg \u6216\u66f4\u4f4e\u65f6\uff0c18F-FMISO \u6355\u83b7\u53ef\u80fd\u4f1a\u589e\u52a0\u3002\u7814\u7a76\u5f97\u51fa\u7ed3\u8bba\uff0c\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u7ec4\u7ec7\u7f3a\u6c27\u5e76\u4e0d\u5c40\u9650\u4e8e\u7ed3\u6784\u5f02\u5e38\u7684\u533a\u57df\uff0c\u4e5f\u53ef\u80fd\u5728\u6ca1\u6709\u4f20\u7edf\u5927\u8840\u7ba1\u7f3a\u8840\u7684\u60c5\u51b5\u4e0b\u53d1\u751f\u3002\u8fd9\u4e00\u53d1\u73b0\u4e0e\u5fae\u8840\u7ba1\u7f3a\u8840\u4e00\u81f4\uff0c\u5f3a\u8c03\u4e86\u9488\u5bf9\u8fd9\u4e9b\u751f\u7406\u53d8\u5316\u91c7\u53d6\u65b0\u578b\u795e\u7ecf\u4fdd\u62a4\u7b56\u7565\u7684\u5fc5\u8981\u6027\u3002<\/p>\n

HRV\u5206\u6790<\/p>\n

\u5fc3\u7387\u53d8\u5f02\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u4e2d\u7684\u4e00\u79cd\u65b0\u5174\u5de5\u5177\uff0c\u53ef\u4e3a\u4e86\u89e3\u81ea\u4e3b\u795e\u7ecf\u7cfb\u7edf\u7684\u529f\u80fd\u63d0\u4f9b\u5b9d\u8d35\u7684\u4fe1\u606f\u3002\u5fc3\u7387\u53d8\u5f02\u662f\u6307\u5fc3\u8df3\u65f6\u95f4\u95f4\u9694\u53d8\u5316\u7684\u751f\u7406\u73b0\u8c61\uff0c\u901a\u8fc7\u5fc3\u8df3\u95f4\u671f\u7684\u53d8\u5316\u6765\u6d4b\u91cf\u3002\u5b83\u53cd\u6620\u4e86\u5fc3\u810f\u5bf9\u5404\u79cd\u751f\u7406\u548c\u73af\u5883\u523a\u6fc0\u505a\u51fa\u53cd\u5e94\u7684\u80fd\u529b\u3002\u5bf9\u4e8e\u60a3\u6709\u521b\u4f24\u6027\u8111\u635f\u4f24\u3001\u8111\u5352\u4e2d\u548c\u5176\u4ed6\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\u7684\u60a3\u8005\uff0c\u5fc3\u7387\u53d8\u5f02\u5206\u6790\u6709\u52a9\u4e8e\u8bc4\u4f30\u81ea\u4e3b\u795e\u7ecf\u529f\u80fd\u969c\u788d\uff0c\u8fd9\u901a\u5e38\u662f\u7ee7\u53d1\u6027\u5e76\u53d1\u75c7\u3002\u5fc3\u7387\u53d8\u5f02\u6307\u6807\u4e0e\u8111\u635f\u4f24\u7684\u4e25\u91cd\u7a0b\u5ea6\u6709\u5173\uff0c\u53ef\u4ee5\u9884\u6d4b\u9884\u540e\u3002\u4f8b\u5982\uff0c\u5fc3\u7387\u53d8\u5f02\u964d\u4f4e\u4e0e\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u7684\u9884\u540e\u4e0d\u826f\u6709\u5173\uff0c\u8868\u660e\u81ea\u4e3b\u795e\u7ecf\u5931\u8c03\u7a0b\u5ea6\u8f83\u9ad8\u3002<\/p>\n

Megjhani \u7b49\u4eba\u5f00\u5c55\u4e86\u4e00\u9879\u7814\u7a76\uff0c\u8bc4\u4f30\u4f7f\u7528\u5fc3\u7387\u53d8\u5f02\u6d4b\u91cf\u68c0\u6d4b\u52a8\u8109\u7624\u6027 SAH \u60a3\u8005\u7684\u795e\u7ecf\u6027\u5fc3\u6e90\u6027\u635f\u4f24\uff08NCI\uff09\u3002\u8be5\u7814\u7a76\u7eb3\u5165\u4e86 326 \u540d\u8fde\u7eed\u5165\u9662\u7684\u60a3\u8005\uff0c\u5176\u4e2d 56 \u4eba\uff0817.2%\uff09\u51fa\u73b0\u4e86 NCI\uff0cNCI \u7684\u5b9a\u4e49\u662f\u5ba4\u58c1\u8fd0\u52a8\u5f02\u5e38\u4f34\u5fc3\u5ba4\u529f\u80fd\u969c\u788d\u6216\u5fc3\u808c\u808c\u9499\u86cb\u767d I \u6c34\u5e73\u5347\u9ad8\uff0c\u4f46\u65e0\u51a0\u72b6\u52a8\u8109\u529f\u80fd\u4e0d\u5168\u7684\u8ff9\u8c61\u3002\u7814\u7a76\u91c7\u7528\u591a\u5c42\u6b21\u7eb5\u5411\u7ebf\u6027\u56de\u5f52\u65b9\u6cd5\uff0c\u68c0\u9a8c\u4e86\u5fc3\u7387\u53d8\u5f02\u6d4b\u91cf\u4e0e NCI \u4e4b\u95f4\u7684\u5173\u7cfb\uff0c\u5e76\u8bc4\u4f30\u4e86\u57fa\u7ebf\u548c\u968f\u65f6\u95f4\u53d8\u5316\u7684\u7ec4\u95f4\u5dee\u5f02\u3002\u7ed3\u679c\u663e\u793a\uff0cNCI \u53d7\u8bd5\u8005\u7684\u8ff7\u8d70\u795e\u7ecf\u6d3b\u52a8\u51cf\u5c11\uff0c\u8868\u73b0\u4e3a\u4f4e\/\u9ad8\u9891\u7387\u6bd4\u503c\u5347\u9ad8\uff0c\u8fd9\u8868\u660e\u4ea4\u611f-\u8ff7\u8d70\u795e\u7ecf\u5e73\u8861\u53d1\u751f\u4e86\u53d8\u5316\uff0c\u8d8b\u5411\u4e8e\u4ea4\u611f\u795e\u7ecf\u6d3b\u52a8\u3002\u6240\u6709\u65f6\u57df\u5fc3\u7387\u53d8\u5f02\u6d4b\u91cf\u503c\u5728\u60a3\u6709SAH\u548cNCI\u7684\u60a3\u8005\u4e2d\u5747\u8f83\u4f4e\u3002<\/p>\n

\u5229\u7528\u96c6\u5408\u673a\u5668\u5b66\u4e60\u65b9\u6cd5\uff0c\u8fd9\u4e9b\u5fc3\u7387\u53d8\u5f02\u6d4b\u91cf\u503c\u88ab\u8f6c\u5316\u4e3a\u4e00\u79cd\u5206\u7c7b\u5de5\u5177\uff0c\u8be5\u5de5\u5177\u5177\u6709\u826f\u597d\u7684\u5206\u8fa8\u80fd\u529b\uff0c\u63a5\u6536\u8005\u64cd\u4f5c\u7279\u5f81\u66f2\u7ebf\u4e0b\u9762\u79ef\uff08AUC-ROC\uff09\u4e3a 0.82\uff0c\u7cbe\u786e\u53ec\u56de\u66f2\u7ebf\u4e0b\u9762\u79ef\u4e3a 0.75\uff0c\u6b63\u786e\u5206\u7c7b\u7387\u4e3a 0.81\u3002\u7814\u7a76\u5f97\u51fa\u7ed3\u8bba\uff1a\u5fc3\u7387\u53d8\u5f02\u6d4b\u91cf\u4e0e NCI \u663e\u8457\u76f8\u5173\uff0c\u4f7f\u7528\u5fc3\u7387\u53d8\u5f02\u884d\u751f\u7279\u5f81\u7684\u673a\u5668\u5b66\u4e60\u6a21\u578b\u53ef\u4ee5\u6709\u6548\u5730\u5bf9\u53d1\u751f NCI \u7684 SAH \u60a3\u8005\u8fdb\u884c\u5206\u7c7b\u3002\u8fd9\u8868\u660e\uff0c\u901a\u8fc7\u673a\u5668\u5b66\u4e60\u6280\u672f\u589e\u5f3a\u5fc3\u7387\u53d8\u5f02\u5206\u6790\uff0c\u53ef\u4ee5\u6210\u4e3a\u65e9\u671f\u68c0\u6d4b SAH \u60a3\u8005 NCI \u7684\u91cd\u8981\u5de5\u5177\u3002<\/p>\n

\u6076\u6027\u7d27\u5f20\u75c7\u548c\u5f25\u6563\u6027\u8111\u767d\u8d28\u75c5\u6bd2\u6027\u767d\u8d28\u75be\u75c5\u7684\u533b\u7597\u7ba1\u7406\u4e5f\u4e0e\u5fc3\u7387\u53d8\u5f02\u6027\u53c2\u6570\u7684\u964d\u4f4e\u6709\u5173\uff0c\u5305\u62ec\u6b63\u5e38-\u6b63\u5e38\u95f4\u9694\u7684\u6807\u51c6\u5dee\u3001\u8fde\u7eed\u6b63\u5e38-\u6b63\u5e38R-R\u95f4\u9694\u5dee\u5f02\u8d85\u8fc750\u6beb\u79d2\u7684\u767e\u5206\u6bd4\u3001\u8fde\u7eedRR\u95f4\u9694\u7684\u5747\u65b9\u6839\uff0c\u4ee5\u53ca\u5fc3\u810f\u71b5\u3002<\/p>\n

Srichawla \u7b49\u4eba\u5bf9\u5fc3\u7387\u53d8\u5f02\u751f\u7269\u53cd\u9988\u6cbb\u7597\u521b\u4f24\u6027\u8111\u635f\u4f24\u540e\u81ea\u4e3b\u795e\u7ecf\u7cfb\u7edf\u5931\u8c03\u7684\u6548\u679c\u8fdb\u884c\u4e86\u7cfb\u7edf\u6027\u8bc4\u4f30\u3002\u7814\u7a76\u53d1\u73b0\uff0c\u53c2\u4e0e\u8005\u5e73\u5747\u63a5\u53d7\u4e86 11 \u6b21\u5fc3\u7387\u53d8\u5f02\u751f\u7269\u53cd\u9988\u6cbb\u7597\uff081 \u81f3 40 \u6b21\u4e0d\u7b49\uff09\u3002\u7ed3\u679c\u8868\u660e\uff0c\u5fc3\u7387\u53d8\u5f02\u751f\u7269\u53cd\u9988\u4e0e\u521b\u4f24\u6027\u8111\u635f\u4f24\u60a3\u8005\u5fc3\u7387\u53d8\u5f02\u7684\u6539\u5584\u6709\u5173\u3002\u6b64\u5916\uff0c\u751f\u7269\u53cd\u9988\u540e\u5fc3\u7387\u53d8\u5f02\u7684\u589e\u52a0\u4e0e\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u6062\u590d\u4e4b\u95f4\u5b58\u5728\u6b63\u76f8\u5173\u3002\u8ba4\u77e5\u548c\u60c5\u7eea\u529f\u80fd\u4ee5\u53ca\u5934\u75db\u3001\u5934\u6655\u548c\u7761\u7720\u95ee\u9898\u7b49\u8eab\u4f53\u75c7\u72b6\u5747\u6709\u6240\u6539\u5584\u3002<\/p>\n

MMM\u548c\u673a\u5668\u5b66\u4e60<\/p>\n

\u5728\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\u5c06 MMM \u4e0e\u673a\u5668\u5b66\u4e60\u76f8\u7ed3\u5408\uff0c\u662f\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u9886\u57df\u7684\u4e00\u5927\u8fdb\u6b65\u3002\u8fd9\u79cd\u878d\u5408\u5229\u7528\u4ece\u5404\u79cd\u76d1\u6d4b\u6a21\u5f0f\uff08\u5982ICP\u3001\u8111\u8840\u6c27\u9971\u548c\u5ea6\u3001\u8111\u7535\u56fe\u548c\u8111\u7ec4\u7ec7\u6c27\u5408\uff09\u83b7\u5f97\u7684\u7efc\u5408\u6570\u636e\uff0c\u901a\u8fc7\u9884\u6d4b\u5206\u6790\u548c\u51b3\u7b56\u652f\u6301\u7cfb\u7edf\u6539\u5584\u60a3\u8005\u6cbb\u7597\u3002\u673a\u5668\u5b66\u4e60\u7b97\u6cd5\u53ef\u4ee5\u5206\u6790\u6765\u81ea MMM \u7684\u5e9e\u5927\u800c\u590d\u6742\u7684\u6570\u636e\u96c6\uff0c\u8bc6\u522b\u4eba\u7c7b\u5206\u6790\u53ef\u80fd\u65e0\u6cd5\u5bdf\u89c9\u7684\u6a21\u5f0f\u548c\u5173\u8054\u3002\u901a\u8fc7\u8fd9\u79cd\u65b9\u6cd5\uff0c\u53ef\u4ee5\u5728\u4e34\u5e8a\u75c7\u72b6\u660e\u663e\u4e4b\u524d\u9884\u6d4b\u5173\u952e\u4e8b\u4ef6\uff0c\u5982\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u3001\u8111\u7f3a\u8840\u6216\u5373\u5c06\u53d1\u751f\u7684\u766b\u75eb\u53d1\u4f5c\u3002\u4f8b\u5982\uff0c\u5145\u5206\u4f7f\u7528 MMM \u4e0e\u5148\u8fdb\u7684\u673a\u5668\u5b66\u4e60\u6280\u672f\u76f8\u7ed3\u5408\uff0c\u53ef\u4ee5\u5728\u8111\u759d\u7efc\u5408\u75c7\u53d1\u751f\u524d\u6570\u5c0f\u65f6\u8bc6\u522b\u51fa\u8111\u759d\u7efc\u5408\u75c7\u3002\u795e\u7ecf\u7f51\u7edc\u3001\u652f\u6301\u5411\u91cf\u673a\u548c\u51b3\u7b56\u6811\u7b49\u7b97\u6cd5\u5df2\u88ab\u5e94\u7528\u4e8e\u795e\u7ecf\u76d1\u6d4b\u6570\u636e\uff0c\u4ee5\u9884\u6d4b\u7ed3\u679c\u5e76\u6307\u5bfc\u6cbb\u7597\u5e72\u9884\u3002<\/p>\n

Tas \u7b49\u4eba\u7814\u7a76\u4e86 MMM \u5728\u5404\u79cd\u6025\u6027\u8111\u635f\u4f24\u6210\u5e74\u60a3\u8005\u4e2d\u7684\u5e94\u7528\uff0c\u5305\u62ec\u521b\u4f24\u6027\u8111\u635f\u4f24\u3001SAH\u3001\u8111\u5185\u51fa\u8840\u3001\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u548c\u5fc3\u810f\u9aa4\u505c\u540e\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\u3002\u8be5\u7efc\u8ff0\u6db5\u76d6\u4e862015\u5e74\u81f32022\u5e74\u7684\u7814\u7a76\uff0c\u786e\u5b9a\u4e86112\u9879MMM\u7814\u7a76\uff0c\u5f3a\u8c03\u4e86\u5927\u591a\u6570\u7814\u7a76\u4e2dICP\u76d1\u6d4b\u4e0e\u8111\u7ec4\u7ec7\u6c27\u5408PbtO2\u7684\u4e3b\u8981\u7ed3\u5408\u3002\u4ed6\u4eec\u7684\u5206\u6790\u8868\u660e\uff0cMMM \u4e3b\u8981\u5e94\u7528\u4e8e TBI \u548c SAH \u75c5\u4f8b\uff0c\u7814\u7a76\u7684\u6837\u672c\u91cf\u4e2d\u4f4d\u6570\u4e3a 36 \u4f8b\u60a3\u8005\uff0c\u5176\u4e2d\u8bb8\u591a\u7814\u7a76\u82b1\u8d39\u4e86 5 \u5e74\u591a\u7684\u65f6\u95f4\u624d\u62db\u52df\u5230\u53c2\u4e0e\u8005\u3002\u7814\u7a76\u5206\u4e3a\u89c2\u5bdf\u6027\u7814\u7a76\uff0868 \u9879\uff09\u548c\u5e72\u9884\u6027\u7814\u7a76\uff0844 \u9879\uff09\uff0c\u5e72\u9884\u6027\u7814\u7a76\u53c8\u5206\u4e3a\u5168\u8eab\u6027\u5e72\u9884\u3001\u8111\u90e8\u5e72\u9884\u548c MMM \u5f15\u5bfc\u4e0b\u7684\u5e72\u9884\u3002\u7edd\u5927\u591a\u6570\uff0882%\uff09\u4ee5 MMM \u4e3a\u6307\u5bfc\u7684\u5e72\u9884\u7814\u7a76\u5c06\u4e34\u5e8a\u7ed3\u679c\u4f5c\u4e3a\u7ec8\u70b9\uff0c\u5176\u4e2d 78% \u7684\u7814\u7a76\u8868\u660e\uff0c\u4ee5 MMM \u4e3a\u6307\u5bfc\u7684\u5e72\u9884\u80fd\u663e\u8457\u6539\u5584\u7ed3\u679c\u3002\u672c\u7efc\u8ff0\u7684\u4e3b\u8981\u5c40\u9650\u6027\u5305\u62ec\uff1a\u4ec5\u7531\u4e00\u4f4d\u4f5c\u8005\u8fdb\u884c\u8bb0\u5f55\u7b5b\u9009\uff0c\u4e14\u672a\u6309\u7167\u516c\u8ba4\u7684 PRISMA \u6307\u5357\u8fdb\u884c\u7cfb\u7edf\u7efc\u8ff0\u3002<\/p>\n

Schweingruber \u7b49\u4eba\u4f7f\u7528\u9012\u5f52\u673a\u5668\u5b66\u4e60\u6a21\u578b\u8fdb\u884c\u4e86\u4e00\u9879\u7814\u7a76\uff0c\u4ee5\u9884\u6d4b\u63a5\u53d7\u6709\u521b ICP \u76d1\u6d4b\u7684\u60a3\u8005 ICP \u7684\u663e\u8457\u589e\u52a0\u3002\u8be5\u7814\u7a76\u4f7f\u7528\u7531 1346 \u540d\u60a3\u8005\u7ec4\u6210\u7684\u673a\u6784\u961f\u5217\uff08ICP-ICU\uff09\u5bf9\u6a21\u578b\u8fdb\u884c\u4e86\u8bad\u7ec3\uff0c\u5e76\u5728\u4e24\u4e2a\u516c\u5f00\u6570\u636e\u96c6\u4e0a\u5bf9\u6a21\u578b\u8fdb\u884c\u4e86\u5916\u90e8\u9a8c\u8bc1\uff1a\u91cd\u75c7\u76d1\u62a4\u533b\u7597\u4fe1\u606f\u96c6\u5e02\uff08MIMIC\uff0c998 \u540d\u60a3\u8005\uff09\u548c\u6025\u8bca\u91cd\u75c7\u76d1\u62a4\u5ba4\u5408\u4f5c\u7814\u7a76\u6570\u636e\u5e93\uff08eICU\uff0c1634 \u540d\u60a3\u8005\uff09\u3002\u8fd9\u4e9b\u6a21\u578b\u65e8\u5728\u9884\u6d4b\u672a\u6765\u6570\u5c0f\u65f6\u5185\u8d85\u8fc7 2 \u5c0f\u65f6\u7684 ICP \u5347\u9ad8 22 mmHg\u3002\u7814\u7a76\u8bc4\u4f30\u4e86\u5371\u6025\u9636\u6bb5\u524d 24 \u5c0f\u65f6\u5185\u4e0d\u540c\u65f6\u95f4\u95f4\u9694\u7684\u9884\u6d4b\u6027\u80fd\uff0c\u53d1\u73b0\u65f6\u95f4\u95f4\u9694\u8d8a\u957f\uff0c\u6027\u80fd\u8d8a\u4f4e\u3002\u4e0d\u8fc7\uff0c\u5373\u4f7f\u5728 24 \u5c0f\u65f6\u5185\uff0c\u6a21\u578b\u4e5f\u80fd\u8868\u73b0\u51fa\u7a33\u5065\u7684 AUC-ROC\uff08ICP-ICU\uff1a0.826\uff1bMIMIC\uff1a0.836\uff1beICU\uff1a0.779\uff09\uff0c\u800c\u5728\u8f83\u77ed\u7684\u65f6\u95f4\u95f4\u9694\u5185\uff081 \u5c0f\u65f6 AUC-ROC\uff1aICP-ICU\uff1a0.982\uff1bMIMIC\uff1a0.965\uff1beICU\uff1a0.941\uff09\uff0c\u6a21\u578b\u7684 AUC-ROC \u5219\u66f4\u9ad8\u3002\u57fa\u4e8e\u957f\u77ed\u671f\u8bb0\u5fc6\uff08LSTM\uff09\u7684\u673a\u5668\u5b66\u4e60\u6a21\u578b\u53ef\u5728\u7a00\u758f\u7684\u6bcf\u5c0f\u65f6\u6570\u636e\u4e0a\u8fd0\u884c\uff0c\u5e76\u80fd\u5904\u7406\u8f93\u5165\u957f\u5ea6\u53ef\u53d8\u548c\u6570\u636e\u7f3a\u5931\u7684\u95ee\u9898\u3002\u7814\u7a76\u8fd8\u5e94\u7528\u4e86\u57fa\u4e8e\u68af\u5ea6\u7684\u7279\u5f81\u91cd\u8981\u6027\u5206\u6790\u6765\u63ed\u793a\u6a21\u578b\u7684\u51b3\u7b56\u8fc7\u7a0b\uff0c\u4ece\u800c\u63d0\u9ad8\u4e86\u6a21\u578b\u7684\u4e34\u5e8a\u53ef\u89e3\u91ca\u6027\u3002\u7814\u7a76\u7ed3\u679c\u8868\u660e\uff0c\u9012\u5f52\u673a\u5668\u5b66\u4e60\u6a21\u578b\uff0c\u5c24\u5176\u662f\u57fa\u4e8e LSTM \u7684\u6a21\u578b\uff0c\u53ef\u4ee5\u6210\u4e3a\u9884\u6d4b ICP \u5347\u9ad8\u7684\u6709\u6548\u5de5\u5177\uff0c\u5728\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u9886\u57df\u5177\u6709\u5f88\u9ad8\u7684\u8f6c\u5316\u6f5c\u529b\u3002\u8be5\u7814\u7a76\u6d89\u53ca\u9884\u6d4b ICP \u968f\u65f6\u95f4\u7684\u53d8\u5316\uff0c\u8fd9\u672c\u8eab\u5c31\u662f\u4e00\u79cd\u987a\u5e8f\u6570\u636e\u3002LSTM \u7b49\u9012\u5f52\u6a21\u578b\u65e8\u5728\u901a\u8fc7\u4fdd\u6301\u5bf9\u5148\u524d\u8f93\u5165\u7684\u8bb0\u5fc6\u6765\u5904\u7406\u65f6\u95f4\u5e8f\u5217\u6570\u636e\u3002\u8fd9\u5bf9\u4e8e\u6839\u636e\u8fc7\u53bb\u7684\u8d8b\u52bf\u51c6\u786e\u9884\u6d4b\u672a\u6765\u4e8b\u4ef6\u81f3\u5173\u91cd\u8981\u3002\u5b83\u4eec\u53ef\u4ee5\u5904\u7406\u6570\u636e\u6536\u96c6\u4e2d\u7684\u4e0d\u4e00\u81f4\u6027\uff0c\u8fd9\u5728\u4e34\u5e8a\u73af\u5883\u4e2d\u5f88\u5e38\u89c1\u3002\u9274\u4e8e\u5176\u590d\u6742\u6027\uff0c\u5b58\u5728\u5bf9\u8bad\u7ec3\u6570\u636e\u8fc7\u5ea6\u62df\u5408\u7684\u98ce\u9669\uff0c\u8fd9\u4f1a\u964d\u4f4e\u6a21\u578b\u5728\u65b0\u7684\u672a\u89c1\u6570\u636e\u4e0a\u7684\u6027\u80fd\u3002<\/p>\n

MASTER-TBI \u9879\u76ee\u662f\u4e00\u9879\u591a\u4e2d\u5fc3\u7eb5\u5411\u961f\u5217\u7814\u7a76\uff0c\u91c7\u7528\u65b0\u578b\u6df7\u5408\u4e91\u5e73\u53f0\u548c\u6570\u636e\u79d1\u5b66\u6280\u672f\uff0c\u6536\u96c6\u548c\u5206\u6790\u5728\u6fb3\u5927\u5229\u4e9a\u4e09\u5bb6\u521b\u4f24\u91cd\u75c7\u76d1\u62a4\u5ba4\u63a5\u53d7 ICP \u76d1\u6d4b\u548c ICM+\u00ae (Cambridge Enterprise) \u795e\u7ecf\u76d1\u6d4b\u7684\u4e2d\u91cd\u5ea6 TBI (m-sTBI) \u60a3\u8005\u7684\u6570\u636e\u3002\u5408\u4f5c\u91c7\u7528\u6df7\u5408\u4e91\u5e73\u53f0\u8fdb\u884c\u6570\u636e\u5b58\u50a8\u548c\u7ba1\u7406\u3002\u6df7\u5408\u4e91\u5e73\u53f0\u5c06\u4f01\u4e1a\u5185\u90e8\u57fa\u7840\u8bbe\u65bd\uff08\u6216\u79c1\u6709\u4e91\uff09\u4e0e\u516c\u5171\u4e91\u76f8\u7ed3\u5408\uff0c\u53ef\u7075\u6d3b\u3001\u53ef\u6269\u5c55\u4e14\u66f4\u5b89\u5168\u5730\u5904\u7406\u6570\u636e\u3002\u8fd9\u5728\u533b\u7597\u4fdd\u5065\u73af\u5883\u4e2d\u5c24\u5176\u6709\u7528\uff0c\u56e0\u4e3a\u5728\u8fd9\u4e9b\u73af\u5883\u4e2d\u4f1a\u4ea7\u751f\u5927\u91cf\u654f\u611f\u6570\u636e\uff0c\u9700\u8981\u5728\u9075\u5b88\u6570\u636e\u4fdd\u62a4\u6cd5\u89c4\u7684\u540c\u65f6\u9ad8\u6548\u5904\u7406\u8fd9\u4e9b\u6570\u636e\u3002\u91c7\u96c6\u7528\u4e8e\u5206\u6790\u7684\u6570\u636e\u5305\u62ec\u75c5\u7406\u751f\u7406\u4e8b\u4ef6\u3001\u624b\u672f\u5e72\u9884\u3001\u4f4f\u9662\u65f6\u95f4\u548c\u91cd\u75c7\u76d1\u62a4\u5ba4\u4f4f\u9662\u65f6\u95f4\u3001\u60a3\u8005\u51fa\u9662\u72b6\u6001\u4ee5\u53ca\u683c\u62c9\u65af\u54e5\u7ed3\u679c\u8bc4\u5206\u6269\u5c55\uff08\u5982\u679c\u6709\uff096 \u4e2a\u6708\u3002\u8be5\u7814\u7a76\u5f3a\u8c03\u4e86\u5728MASTER-TBI\u5408\u4f5c\u9879\u76ee\u4e2d\u5f00\u53d1\u4ee5\u6570\u636e\u79d1\u5b66\u4e3a\u57fa\u7840\u7684\u7cfb\u7edf\u548c\u6280\u672f\uff0c\u76ee\u7684\u662f\u6700\u5927\u9650\u5ea6\u5730\u5229\u7528\u9ad8\u5206\u8fa8\u7387m-sTBI\u60a3\u8005\u795e\u7ecf\u76d1\u6d4b\u6570\u636e\u3002\u636e\u4ecb\u7ecd\uff0c\u6240\u5f00\u53d1\u7684\u7cfb\u7edf\u5177\u6709\u521b\u65b0\u6027\u548c\u4e16\u754c\u4e00\u6d41\u6c34\u5e73\uff0c\u6709\u53ef\u80fd\u663e\u8457\u6539\u5584 m-sTBI \u60a3\u8005\u7684\u62a4\u7406\u548c\u6cbb\u7597\u6548\u679c\u3002<\/p>\n

\u7ed3\u8bba<\/p>\n

\u5c06\u795e\u7ecf\u7269\u7406\u539f\u7406\uff08\u5305\u62ec\u8111\u8840\u6d41\u52a8\u529b\u5b66\u548c\u80fd\u91cf\u5b66\uff09\u3001MMM \u548c\u4f7f\u7528\u673a\u5668\u5b66\u4e60\u7b97\u6cd5\u7684\u9ad8\u7ea7\u6570\u636e\u79d1\u5b66\u5206\u6790\u6574\u5408\u5728\u4e00\u8d77\uff0c\u4e3a\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u9886\u57df\u63d0\u4f9b\u4e86\u4e00\u4e2a\u524d\u666f\u5e7f\u9614\u7684\u4ea4\u53c9\u70b9\u3002\u672a\u6765\u8fd8\u5c06\u53d6\u5f97\u66f4\u591a\u8fdb\u5c55\uff0c\u5305\u62ec\u8bc4\u4f30 ICP\u3001\u8111\u6c27\u9971\u548c\u5ea6\u548c\u4f53\u6e29\u7684\u4e09\u8154\u9885\u5185\u76d1\u62a4\u4eea\uff0c\u4ee5\u53ca\u540c\u6b65 PbtO2-EEG\u3001NIRS-EEG \u548c\u9006\u884c\u900f\u6790\u3002\u5c06\u8fd9\u4e9b\u5de5\u5177\u4e0e\u5148\u8fdb\u7684\u673a\u5668\u5b66\u4e60\u6a21\u578b\u7ed3\u5408\u4f7f\u7528\uff0c\u53ef\u4ee5\u6539\u5584\u91cd\u75c7\u76d1\u62a4\u5ba4\u5185\u7684\u9884\u6d4b\u5efa\u6a21\u3002\u4f8b\u5982\uff0c\u5728 SAH \u53d1\u751f\u524d\u6570\u5c0f\u65f6\u6216\u6570\u5929\u5bf9\u9885\u5185\u9ad8\u538b\u3001\u76f8\u5173\u8111\u759d\u7efc\u5408\u5f81\u548c\u5ef6\u8fdf\u6027\u8111\u7f3a\u8840\u8fdb\u884c\u4f30\u8ba1\u3002\u6b64\u5916\uff0c\u66f4\u597d\u5730\u4e86\u89e3\u6025\u6027\u8111\u635f\u4f24\u7684\u6f5c\u5728\u8111\u751f\u7406\u5b66\u5c06\u4e3a\u6cbb\u7597\u63d0\u4f9b\u66f4\u591a\u7684\u9014\u5f84\u3002\u56e0\u6b64\uff0c\u795e\u7ecf\u5185\u79d1\u533b\u751f\u7684\u89d2\u8272\u6b63\u5728\u4ece\u795e\u7ecf\u9884\u540e\u8005\u8f6c\u53d8\u4e3a\u795e\u7ecf\u4fdd\u62a4\u8005\u3002\u7136\u800c\uff0c\u7ee7\u7eed\u63a8\u8fdb\u6211\u4eec\u7684\u6280\u672f\u548c\u65b9\u6cd5\u4ee5\u8fdb\u4e00\u6b65\u63d0\u9ad8\u6211\u4eec\u5bf9\u795e\u7ecf\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\u7684\u8111\u751f\u7406\u5b66\u548c\u60a3\u8005\u6cbb\u7597\u7684\u7406\u89e3\u662f\u81f3\u5173\u91cd\u8981\u7684\u3002<\/p>\n

\u6765\u6e90\uff1aSrichawla BS. Future of neurocritical care: Integrating neurophysics, multimodal monitoring, and machine learning. World J Crit Care Med 2024; 13(2): 91397 [DOI: 10.5492\/wjccm.v13.i2.91397]<\/p>\n

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