Bài viết trình bày đánh giá sự thay đổi SjvO2 trong quá trình phẫu thuật bệnh nhân chấn thương sọ não nặng. Nghiên cứu tiến cứu mô tả trên 50 bệnh nhân chấn thương sọ não nặng được phẫu thuật. Chỉ số SjvO2 (đo liên tục tại hành tĩnh mạch cảnh) và ghi nhận giá trị tại các thời điểm: trước mổ (T1), sau mở xương sọ (T2), sau mở màng cứng (T3), sau lấy khối choán chỗ (T4), và sau mổ 30 phút (T5),... Mời các bạn cùng tham khảo.
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