Preliminary Study On The Monitoring Of Partial Pressure Of Brain Tissue Oxygen Combined With Intracranial Pressure To Guide The Treatment Of Traumatic Brain Injury

Objective:To observe and compare the changes of partial pressure of oxygen in brain tissue and intracranial pressure after brain injury,and to evaluate the feasibility of partial pressure of oxygen in brain tissue as an index for monitoring the degree of brain tissue injury after secondary brain injury;To observe the changes of partial pressure of oxygen in brain tissue and intracranial pressure after brain injury,and to explore the feasibility of applying partial pressure of oxygen in brain tissue to observe the degree of brain injury;To analyze the current evidence on the effect of combined Pbt O₂/ICP-guided therapy on the prognosis of patients with Traumatic Brain Injury（TBI）.Methods:A secondary brain injury model was established,and the changes in brain water content and neurological function scores before and after the injury were observed,as well as the changes in brain tissue oxygen partial pressure and intracranial pressure were observed and compared;From November 2021 to August 2022 in the Neurosurgery Department of Neurosurgery of the General Hospital of Xinjiang Military Region,6 patients with brain injury were treated in an observational study.All 6 patients were implanted with a brain tissue oxygen partial pressure monitoring probe and The intracranial pressure monitoring probe was used to observe the changes of Pbt O₂and ICP before and after the operation,as well as the prognosis after 6 months;Electronic retrieval of Pub Med,Scopus,Cochrane Library,China National Knowledge Infrastructure,Wanfang and VIP databases（as of the end of September 2022）,and collection of randomized controlled related research.Only the research of comparison between Pbt O₂/ICP guidance and icp guidance was selected for comparison,and the literature/extraction materials were selected according to the inclusion and exclusion criteria,and the quality of methodology was evaluated.The quality of these tests was evaluated.Data extraction and analysis were carried out by using Review Manage5.3 software.Results:After brain injury,the water content of the ipsilateral and contralateral brain tissue of the model animals increased significantly;at the same time,the ICP of the model at each time point was significantly higher than the ICP value before modeling,and the Pbt O₂value was correspondingly higher than that of the model;Among the 6 patients,1 died and 3 patients had a good prognosis;Intraoperative and postoperative monitoring of Pbt O₂and ICP revealed that Pbt O₂continued to decrease from day 1 to day 5,while ICP continued to increase;from day 6 onwards,Pbt O₂gradually increased,while ICP gradually decreased;the two showed a"negative"correlation trend;Of the 7584 studies retrieved,19 studies（n=37459 patients）entered the final analysis.Combined use of Pbt O₂/ICP-guided therapy was associated with better neurological outcome（OR 2.26[95%CI 1.75-2.93]）and higher survival（OR 1.19[95%CI1.07-1.32]）correlation.Heterogeneity(I²)among the studies in each analysis was below 40%.Conclusion:After brain injury,Pbt O₂changes and ICP are in a"negative"correlation change rule,which may provide another monitoring method for secondary brain injury;Pbt O₂and ICP have similar sensitivities for the monitoring of secondary brain injury,and Pbt O₂may become another means of monitoring the degree of brain injury after secondary brain injury;Pbt O₂/ICP combined with monitoring to guide the treatment of brain injury is related to the reduction of mortality and better prognosis of neurological function in patients with brain injury.