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脑氧饱和度在胸外科单肺通气手术中应用的研究进展
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Abstract:
大脑具有高代谢、高氧耗、有限的能量储存能力及低缺氧耐受性的特点，维持充足的血液灌注和氧气输送对大脑代谢至关重要，脑缺血可导致脑血管系统的结构和功能损伤，从而导致增加术中术后认知功能障碍以及神经系统并发症的风险。近年胸外科治疗技术得到了快速发展，支气管麻醉也得到了广泛的应用，然而，单肺通气(one-lung ventilation, OLV)过程中导致的肺内分流及通气血流比值失调，可能引发低氧血症。脑氧饱和度(regional cerebral oxygen saturation, rScO2)的实时监测，可以有效地反映脑氧合水平，为诊断和治疗提供有价值的信息，对于维持大脑足够的血液灌注和供氧至关重要。
The brain is characterized by high metabolism, high oxygen consumption, limited energy storage capacity and low hypoxia tolerance. Maintaining adequate blood perfusion and oxygen delivery is crucial for brain metabolism, and cerebral ischemia can lead to structural and functional damage of the cerebrovascular system, thus increasing the risk of cognitive dysfunction and neurological complications. In recent years, thoracic surgical treatment techniques have been rapidly developed and bronchial anesthesia has been widely used; however, the intrapulmonary shunt and ventilation-to-blood flow ratio imbalance caused during one-lung ventilation (OLV) may trigger hypoxemia. Real-time monitoring of cerebral oxygen saturation (rScO2) can effectively reflect the level of cerebral oxygenation and provide valuable information for diagnosis and treatment, which is essential for maintaining adequate blood perfusion and oxygenation of the brain.
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