Mối liên quan giữa sự thay đổi của SjvO2 với các giai đoạn phẫu thuật máu tụ trong sọ ở bệnh nhân chấn thương sọ não nặng

9.%!:% !";<=>&";?!@.A!BC%A!-DEFGHA!I
J%8 !K, )LM* F'?!9%8 J%8 !K, + !N.
O.P, <=>#!Q> !>: 3)#!756R&S<=>,+
TUV%8&' !N.O.P,W6X8.Y,%!.Z>%!" F[ACA
\A!]A ^B%8<_ !`A<`OUaA8.Y.#!R%8?!b.
A!c%d#L?!.,+,'%8A]%8W6XFQ%AR !P
.e# fA8.Y,LO.Z>%';8R##!g%8.Y.!hA!A!B
<` J%8,i%!,SAj=DEFGH i.!=.!N.O.P,
%';5D=> ,+ ,'%8 A]%8L%kB Ok !`A <`
OUaA8.Y.#!R%8LF[F:;?!.&";?!@.A!BC%A!^B%8%kBAR !P%!.Z>%!UACA!N.O.P,Og>5
D` !=; O\.DEFGH ^B%8 ,\ Aj= %!R,
/0%! %!1% AR DEFGH ^UlA ,\ 8.Y,
mDEFGH n oo*pq/0%! %!1% OUaA AB.O=%8
^B%8 [%! ^i%8 !.e> ,C> %kB ?!.
DEFGHnoo*5rfAOhA!Aj=O.Z> ^s/0%!%!1%
A!"% !UV%8<_%kB&'t>; ^[DEFGH @ %!"
uv)*5w!xBty.<` !=;O\.Aj=DEFGH Aj=
%!R, %';A!7%8 9.%!:% !";DEFGH <=>,\
J%8,z ACA!AR{%8!|=,]A !=;O\.&'(oLv*m#n)L))(pm/.P>O}Hp5
w^B%8~>C ^[%!,\L!N.O.P, <=>,+TUV%8
A%8&' !N.O.P,DEFGH J%8,i%!%!"L,]A
!=;O\.w>;%!.K%L€<=> !N.O.P, ,+TUV%8Oe%
A>@.A>zA ,\LDEFGH J%8 ?!9%8 OC%8 ?P
m#)L)op56R&S+%!R, /0%!%!1%%';%kB
Ok !.e>,C>%‚%8Fl.,z !N.8.=%t'.%K%
tƒ Ul.,C>OUaAAY.!.0%%!U%8DEFGH FQ%
?!9%8 !P FZ 8.l.!i% /[%! !UN%85D`AY.
!.0%%';FQ%^" Ag%OUaA .e# fA !xBty.OP

%!„%8/.0%#!C#A=% !.0#Ul.,C>%kBL^>;Z%,C>…%e>DEFGH FQ%+
tUl.,]A/[%! !UN%85w^B%8 \%8<@o/0%!
%!1% †FB%8‡T.%FZ ^B%8Mˆ8.N <=>,\Aj=
%8!.K% A]> Ok AR M /0%! %!1% !>zA%!R,
DEFGH 8.Y,5‰!UF:;L!xBty.DEFGH ^" AR8.C
^sOPtQ%tŠ O.Z> ^s%8=; ^B%8,\F' .K%
&Ua%8A!"% !UV%8<_%kB<=>,\5
123

D` !=; O\.DEFGH ^B%8 ,\ Aj= %!R,
/0%!%!1%ARDEFGH €oo* Oe%‹o*q~>=%
!i%/[%! !UN%8LA!7%8 9.%!:% !";!=;O\.
DEFGH ^B%8,\+%!R, %';8.@%8%!U !=;
O\.DEFGH +ACA/0%!%!1%A!"% !UV%8<_
%kB %R.A!>%8 m% Πo)p56R !P !";DEFGH
OUaA AY. !.0% ^y ^0 <=> ,\ m/.P> O} 3p5
DEFGH <=> ,\ J%8 ^>%8 /[%! ˆ5* ^UlA,\m#n)L))(p5DEFGHA%8 J%8 i.ACA
!N.O.P, <=> ,+ TUV%8 mvL3*pL<=> ,+
,'%8A]%8m3LM*p5‰!UF:;,‚AtƒDEFGH+
^B%88.l.!i%/[%! !UN%8L%!U%8?!./0%!
%!1% OUaA,\ 8.Y.b= F' &";,C> fL [%!
^i%8 Ul.,C> %kB .e# fAOUaAAY.!.0%
OC%8?P5
D` !=;O\.DEFGH ^B%8 #!Q> !>: Aj=
%!R, /0%!%!1%ARDEFGH ‹o*qDEFGH Ok
J%8 ^K% ,]A /[%! !UN%8 ^UlA ,\ Aj=
%!R,/0%!%!1%%';ˆMLMŽML)*m‹ˆ)*pL

+ !N.O.P,<=>,+TUV%8<_DEFGH&'ˆoL(Ž
ML* m‹‹(*pL+ !N.O.P, <=>,+,'%8
A]%8&'ˆoL3ŽoLv* m‹M3*pL+ !N.O.P,
<=> &"; ?!@.A!BC% A!- &' ˆoL Ž 3Lˆ*
mˆ)3*pF'<=>,\3)#!7 &'ˆ3LoŽ3Lˆ*
mˆ)ˆˆ*p5w^B%8AY~>C ^[%!,\,]A !=;
O\.DEFGH 8.„=ACA !N.O.P, &'?!9%8AR{
%8!|= Fl.#  )L)o5w^B%8 %8!.K% A]> Aj=
‘x;%xLˆ/0%!%!1% J%8DEFGH&.K%~>=%Oe%
[%! ^i%8A!e %kB2M45w^B%8%8!.K%A]>Aj=
A!7%8 9.L,z /0%!%!1% †FB%8‡T.%FZ ^B%8
Mˆ8.N<=>,\A%8 !>zA%!R, %';5’R&'
/0%!%!1%ARA!I<@DEFGH ^UlA,\A=B%!"
m)*p^B%8o)/0%!%!1%5“!.F'B#!”%8,\L
[%! ^i%8 A!"% !UV%8 <_ %kB ^" %‚%8
m•&=<8B–MO.P,pL\% !UV%8 ^K%#!., A!f#
AŠ &l#&',C> ftUl.,'%8A]%8,z /K%L
,C> f ^B%8%kBLt:#%kB!=./K%/C%Ag>L
Oc O—;OUN%8 8.„=LA!Y;,C> ,'%8 ,Z,
?c, #!ƒ%kBF'TR=/POC;˜OUaAA!IOs%!
#!Q> !>: &";,C> fF'/bTUV%88.Y.b=
4565789
2
12



 !"$%!&'( !)*+%,-+%.&/-0-1234 <1J1J+m`)7 +.!'1712351J<@&1u/7
5-6& 78/"9:3 '(49;<=> ?@ AAB4C:3 7* )-u& +61+%!& 3j +%,- &-1V )`3\+%K
+D&EF7GHAB"IJ--K7LM)N1<2E! +%&)j' {$-9&3Ty$-uT&K<,C_

+,-+%.&O&C:3'(H&1P"
&1u/7%e+-1J33n7U1$D&9;<=> )Q&7LM)-R)7G-L'S+
TG3+U+1V?LM&-W1/-X)+-F51-5Y' Z[\
~
]^"I335<@)S&C_&-1V)`3C_+-:T7(1
9;<=> abcdJ--K-6'VC:3)e/)`3 }}Ă}Â ÊÔƠƠƯĐ}
&f& +3F -!@ +-eT%g&4a-h& dJ- ă!%+:?1+T â%!' +%:3':+1) d%:1 1;3%T"êôơư
-K+i[ 4đôààảãáƯ4>Aạ>Ax"
&1P&f&+3F-!@Zl^"m123@T/-nj- Ô}ằẳẳĂẵ }ắ ÊÔƠƠĐ"31E?1 â!%+-
C_&1n' +1V3+-X!NT ! E!+,-+%.& ! 93%&1):? ă::&'+ !â $%:3':+1) I%:1
'e+)-`)D&o+,-+%.&)-G+ !p)Q&?@ ;3%Tã4đđ4ƯÊặĐ49>ạ9>b"
'S++%!&-h&&3TV-K&KT+D&9;<=>" ặ} Ăầẩẫ ấ} ÊááĐ} +%:!/%:+1<
q-1 !+-1G3'j3%S&4'e+5-nD&?eT!NT ậ3&3?:%èC:+3%:+1!è3%1&93%&%T!%$%:3
+-,<1J)/-r3+-38+)Q&5-6&)n1+-1J7LM) ':+1)+%:)%:1:?':+!':C"êẻđơ êẻưả"
+,- +%.& +Ls1'j3  !"$%!& &-1V )`3 ặ4ạcạ[ạc>ạ"
)t:)-u&+61)-v)*AdJ--K)*+,-+%.& ẽ}éẹéẹềẹ}éẹềẹẹẹ}ẳẳẹ
9;<=> +D& ow lxBpV )-L: +-k 7j- &1j ÊááĐ"ể:?TC1C !â<%T :%?T ;3&3?:%d3?d
7FT7tE1yd1G)t:9;<=> +%!&<@C:3'(" !N1'+%T E:+: :â+% C<% -:E 1;3%Tễ
mKT)Q&)-z-?@-.)-G)t:&-1V)`34 1'/?1):+1!Câ!%+-'%&)T'::&'+ế
dJ--K?s-{<@+-P1&1:E@1-{"
Ư}ĂĂ}|ẳĩẵ }ằ}ắĂíẹẩÂĂ
}ấÊáááĐ"ị?<:+E ;3&3?:%<!3C!NT&
|}~
:+3%:+1!:â+%C<%-:E1;3%Tãì4đ

I !-:!NT+-'.)-)n-o9;<=>p+D& C
?V 'S+)j)- )* &-: +-U& 5V C:3 5-1 êẻđơđả4áƠ4Hạx"
'a NL{& C <@ 'a '@& )`& C!

+%Ls)'(a)j)dJ--K)-e+-L{&C ÂẩĂ |} ÊÔƠƠĐ")%:CE ;3&3?:%d3?d
 !O&"9;<=>+D&?V'S+)j)-7j&5kC:3 C:+3%:+1!1C:CC!)1:+Eỏ1+-/!!%!3+)!'1
'(C!9;<=>xxB <@9;<=> +fxx7GlxB4-L& õôươ"óƠ4ạcạạc["
5-6&+-:T7(1a-*')*9;<=>wlxB"
ó} ằẵ } ọ ĩẹ Ăẹọẹ }}
ẹĩẹÂ}ÊáááĐ"ồ%!&!C+1)C1&1â1):)

!â+-E1ââ%)d+ỏ'1NE<!3C:E
-*' &-1V )`3 N1 +%K +%& )n' { ;3&3?:%d3?d !NT& C:+3%:+1! 1 )!':+!C
)j)dj)C47123ELP&/-&'()e/)`3<@ /:+1+C %C3C)1+:+E â%!' : ):%E1:) :%%C+ã
-W1C`)+z)-)_)45-!:KT'VW1C`)4dJ- ổđôơươẻẽÊặĐ4>xl>]>"

234356789










 !!"#$
%&'()&)*+,'('*',-(
(,(.*(,/,(,,'-%(,-',

12344567894:;<=>53?= @A45: =?AB6A5= >2ACD=4:EF6D6BAG;6B; :H8D=C 4A56GA53:C IJ76G3CD46GD=G8E:G4=?=G=2=A73C<6G=7NA53=C54OPNG:4N=>53?=45678@A4>:C76>5=7:CQR4=?=G=

2=A7 3C<6G=7 NA53=C546C7=GD:3CD >GAC3:5:S846GD=G8OTG=:N=GA53?= JS=A46G=7AE5=GAC=452=43A 3C76>53:C ;8A >A52=5=G>:CC=>53CD 5: U=VKWS:C35:GOJ:;4=G?=7>:C53C6:64B876G3CD46D=G8AC7G=>:G7=7A573EE=G=C5N2A4=4X;=E:G=46GD=G8I1YMZAE5=G
>GAC3:5:S8I1LMZAE5=G76G:5:S8I1[MZAE5=GG=S:?3CD 2=SA5:SA I1\MAC7 3C [R S3C65=4AE5=G
46GD=G8I1QMOJ<?KL@A43C52=C:GSABGACD=3CQL] :ENA53=C54ZG=76>=73C[L] AC73C>G=A4=73C
Y^] :ENA53=C54OJ<?KL 3C>G=A4=743DC3E3>AC5B876G3CD46GD=G8Z=4N=>3ABB8AE5=G>GAC3:5:S8AC7
76G:5:S8>:SNAG=75:52=NG=:N=GA53?=N2A4=I^_OY ` Y[OL] AC7 aRO[ ` Y[OY] ?4O^YOb`
YQO^]ZNcRORQMOJ<?KL737C:5>2ACD=43DC3E3>AC5B83C52=NA53=C54@352NG=:N=GA53?=JeC>:C>B643:CZJ<?KL3C>G=A4=743DC3E3>AC5B8AE5=G>GAC3:5:S8AC776G:5:S83C4=?=G=2=A7fC<6G=7
NA53=C54@352B:@:GC:GSABNG=:N=GA53?=Jgh$ij#klmnh"kopq#$rqs*t

123

45657839
2
12