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目的 探讨急性河豚毒素 (TTX)中毒患者颈静脉血氧饱和度 (SjO2 )、动脉 颈内静脉血氧含量差 (AVDO2 )、脑氧摄取 (CEO2 )变化与预后的关系。方法 观察 34例TTX中毒患者 6～ 12h、 2 4h、 4 8h、 72h、 7d各时间点SjO2 、AVDO2 、CEO2 的变化。结果 TTX中毒患者入院 6～ 12h时SjO2 、AVDO2 、CEO2 明显高于对照组 (P <0 0 5 ) ,入院 2 4h后TTX中毒患者SjO2 逐渐恢复正常 ,但重度组AVDO2 、CEO2 明显低于对照组 (P <0 0 1) ,当CEO2 低于 2 5 %时 ,患者预后差。结论 脑氧供需平衡变化反映了TTX中毒患者大脑神经细胞的机能和利用氧的能力 ,因此可将脑氧供需平衡变化作为判断TTX中毒预后的重要指标
Objective To investigate the relationship between the changes of SjO2, AO2O2, CEO2 and prognosis in patients with acute tetrodotoxin (TTX) poisoning. Methods The changes of SjO2, AVDO2 and CEO2 in 34 TTX patients at 6, 12, 24, 48, 72 and 7 days were observed. Results The levels of SjO2, AVDO2 and CEO2 in TTX poisoning patients were significantly higher than those in control group (P <0.05) at 6-12 h admission. SjO2 gradually returned to normal level in TTX poisoning patients 24 hrs after admission, but the levels of AVDO2 and CEO2 in severe group were significantly lower than those in control group (P <0.01). When CEO2 was less than 25%, the prognosis was poor. Conclusion The balance between supply and demand of brain oxygen reflects the function of brain cells and the ability to use oxygen in patients with TTX poisoning. Therefore, the balance between supply and demand of brain oxygen can be used as an important index to judge the prognosis of TTX poisoning