| Background:Traumatic brain injury(TBI)changes rapidly,has many complications,and has a high case fatality rate.It seriously threatens people’s lives and health,increases the economic burden on families and society,and has become one of the main diseases threatening human lives in today’s society.China is the largest developing country with the largest population,and the number of TBI patients is far higher than any other country.After brain injury,a variety of reasons lead to cerebral ischemia and hypoxia.According to related literature,the incidence of hypoxemia in patients with brain injury is as high as 65%.And after TBI occurs,the blood-brain barrier(BBB)and bloodcerebrospinal fluid barrier(BCSFB)are damaged,resulting in dysfunction of the blood-brain barrier and blood-cerebrospinal fluid,making even the arterial blood oxygen partial pressure(PaO2)returned to normal but the oxygen partial pressure of cerebrospinal fluid(PcsfO2)was still at a low level.PcsfO2 refers to the tension of physical dissolved oxygen in the cerebrospinal fluid,which reflects the degree of cerebral hypoxia.Therefore,this study adopted the observation index about the oxygen partial pressure of CSF to explore the oxygen partial pressure of CSF and the oxygencarrying capacity of CSF in patients with TBI.Objective:In this study,the oxygen partial pressure of cerebrospinal fluid(CSF)was used as an observation index to explore the oxygen partial pressure of CSF and the oxygencarrying capacity of CSF in patients with TBI.Method:Eight patients with moderate to severe traumatic brain injury(mtsTBI)and eight patients with mild traumatic brain injury(mTBI)were selected firom the intensive care unit and the general ward of the Third Affiliated Hospital of Southern Medical University from January 2019 to December 2O20.All the 8 mtsTBI patients underwent equivalent amount of cerebrospinal fluid replacement(20ml).Specific methods:strictly control aseptic operation,.50ml pure oxygen was added into 100ml normal saline,and they were fully mixed.20ml was extracted as replacement fluid,and the cerebrospinal fluid was extracted through the three-way valve of lumbar cistern/ventricle drainage tube,and high-dissolved oxygen normal saline was injected.The oxygen partial pressure of cerebrospinal fluid(PcsfO2)were measured.before or after CSF replacement for one,two,three,four times and 10min,20min,30min,60min and 24h after four times of cerebrospinal fluid replacement The above detection indexes were used to analyze the oxygen partial oxygen pressure of CSF in TBI patients and the improvement space of CSF partial oxygen pressure in mtsTBI patients by CSF replacement(the replacement fluid was high dissolved oxygen normal saline).Result:The oxygen partial pressure of cerebrospinal fluid in mtsTBI patients was significantly lower than that in patients with mTBI(concussion.).In mtsTBI patients,the oxygen partial pressure of CSF in the ventricle was significantly higher than that in the lumbar cistern(i.e.,the subarachnoid space).In mtsTBI patients,the space of improvement about oxygen partial pressure of CSF by withdrawing CSF from the lumbar cistern was greater than that by withdrawing CSF from the ventricle.These differences were statistically significant(P<0.05),Conclusion:In summary,the detection of cerebrospinal fluid oxygen partial pressure can clearly reflect the hypoxia of the body early and clearly.Patients with TBI have different degrees of hypoxia,and there are certain differences in the cerebrospinal fluid oxygen partial pressure in different parts(ventricles,lumbar cistern).And the ventricle is higher than the lumbar cistern(subarachnoid space);The treatment of cerebrospinal fluid replacement(the replacement fluid is high dissolved oxygen normal saline)through lumbar cisterna can significantly improve the oxygen partial pressure of cerebrospinal fluid in patients with TBI,that is,improve the internal environment for the survival and metabolism of brain tissue in patients with TBI. |
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