重型颅脑损伤行有创颅内压监测的临床价值评估(1)
[摘要] 目的 的探究重型顱脑损伤在使用有创颅内压监测后的临床价值。 方法 研究对象为方便选取该院2016年10月—2017年10月收治的88例重型颅脑损伤患者，将其采用随机数字表法分成治疗1组与治疗2组，44例治疗1组采用有创颅内压监测，另44例监测2组采用常规传统方法监测患者的颅内压变化。探讨实施不同监测对颅内压、格拉斯哥昏迷评分法(GCS)及并发症的影响。 结果 监测1组在术后1、3、7、10 d[(26.27±2.53)mmHg、(20.41±2.74)mmHg、(12.57±1.36)mmHg、(11.13±1.14)mmHg]时颅内压显著比监测2组[(27.86±2.41)mmHg、(24.19±2.63)mmHg、(17.61±1.52)mmHg、(14.76±1.53)mmHg]低(t=3.018、6.602、16.391、12.620，P<0.05)，在GCS评分上，在1、3、7、10 d时[(6.43±0.61)分、(7.96±0.72)分、(9.25±0.95)分、(11.34±1.26)分]显著比监测2组[(6.03±0.63)分、(6.87±0.65)分、(7.78±0.76)分、(9.51±0.94)分]高(χ2=3.026、7.454、8.015、7.722，P<0.05)，且在并发症发生率上，监测1组(2.27%)显著比监测2组(15.91%)少(χ2=4.950，P<0.05)。 结论 将有创颅内压监测应用于重型颅脑损伤患者后，能及时发现患者颅内压变化，从而采取有效治疗措施，避免颅内压进一步升高的同时，持续改善颅内压水平，提升GCS评分，有效避免并发症的产生，此方法值得应用与推广。
[关键词] 重型颅脑损伤；颅内压；有创颅内压监测；应用价值
[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742(2018)08(a)-0089-03
Clinical Evaluation of Intracranial Pressure Monitoring for Severe Brain Injury
WU Qiu-tao， ZHAO Ding-ding， YE Yu-hu， SUN Xing-wu， ZHANG Ye-bin， ZHANG Jia-xing， ZHU Che-fu， LI Pei-xing
Department of Neurosurgery， Guangming New District People's Hospital， Shenzhen， Guangdong Province， 518107 China
[Abstract] Objective To explore the clinical value of severe craniocerebral injury after using intracranial pressure monitoring. Methods Convenient select 88 patients with severe craniocerebral injury admitted to the hospital from October 2016 to October 2017 were randomly divided into treatment group 1 and treatment group 2 using the random number table method. Intracranial pressure monitoring was performed on 44 patients in treatment group 1 and 44 patients in treatment group 2， conventional methods were used to monitor changes in intracranial pressure. To investigate the effects of different monitoring on intracranial pressure， Glasgow Coma Scale (GCS)， and complications. Results The intracranial pressure of group 1 was significantly higher than that of group 2[(27.86±2.41)mmHg， (24.19±2.63)mmHg，(17.61±1.52)mmHg，(14.76±1.53)mmHg] at 1， 3， 7， and 10 days after operation [(26.27±2.53)mmHg， (20.41±2.74)mmHg， (12.57±1.36)mmHg， and (11.13±1.14)mmHg， was lower (t=3.018， 6.602，16.391， 12.620， P<0.05)， and on the GCS scores at 1， 3， 7， and 10 days[(6.43±0.61)points， 7.96±0.72)points， 9.25±0.95)points and (11.34±1.26)points] were significantly higher than those of the two monitoring groups[(6.03±0.63)points，(6.87±0.65)points，(7.78±0.76)points， and (9.51±0.94)points](χ2=3.026， 7.454， 8.015， 7.722， P<0.05). The incidence of complications was significantly lower in the monitoring group (2.27%) than in the monitoring group (15.91%) (χ2=4.950， P<0.05). Conclusion Intracranial pressure monitoring can be applied to patients with severe brain injury， and the change of intracranial pressure can be detected in time， so that effective treatment measures can be taken to avoid further increase of intracranial pressure， and the level of intracranial pressure can be continuously improved. The GCS score can effectively avoid the occurrence of complications. This method is worthy of application and promotion., 百拇医药(吴秋涛 赵丁丁 冶玉虎 孙兴武 张业斌 张加星 朱车甫 李培兴)
[关键词] 重型颅脑损伤；颅内压；有创颅内压监测；应用价值
[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742(2018)08(a)-0089-03
Clinical Evaluation of Intracranial Pressure Monitoring for Severe Brain Injury
WU Qiu-tao， ZHAO Ding-ding， YE Yu-hu， SUN Xing-wu， ZHANG Ye-bin， ZHANG Jia-xing， ZHU Che-fu， LI Pei-xing
Department of Neurosurgery， Guangming New District People's Hospital， Shenzhen， Guangdong Province， 518107 China
[Abstract] Objective To explore the clinical value of severe craniocerebral injury after using intracranial pressure monitoring. Methods Convenient select 88 patients with severe craniocerebral injury admitted to the hospital from October 2016 to October 2017 were randomly divided into treatment group 1 and treatment group 2 using the random number table method. Intracranial pressure monitoring was performed on 44 patients in treatment group 1 and 44 patients in treatment group 2， conventional methods were used to monitor changes in intracranial pressure. To investigate the effects of different monitoring on intracranial pressure， Glasgow Coma Scale (GCS)， and complications. Results The intracranial pressure of group 1 was significantly higher than that of group 2[(27.86±2.41)mmHg， (24.19±2.63)mmHg，(17.61±1.52)mmHg，(14.76±1.53)mmHg] at 1， 3， 7， and 10 days after operation [(26.27±2.53)mmHg， (20.41±2.74)mmHg， (12.57±1.36)mmHg， and (11.13±1.14)mmHg， was lower (t=3.018， 6.602，16.391， 12.620， P<0.05)， and on the GCS scores at 1， 3， 7， and 10 days[(6.43±0.61)points， 7.96±0.72)points， 9.25±0.95)points and (11.34±1.26)points] were significantly higher than those of the two monitoring groups[(6.03±0.63)points，(6.87±0.65)points，(7.78±0.76)points， and (9.51±0.94)points](χ2=3.026， 7.454， 8.015， 7.722， P<0.05). The incidence of complications was significantly lower in the monitoring group (2.27%) than in the monitoring group (15.91%) (χ2=4.950， P<0.05). Conclusion Intracranial pressure monitoring can be applied to patients with severe brain injury， and the change of intracranial pressure can be detected in time， so that effective treatment measures can be taken to avoid further increase of intracranial pressure， and the level of intracranial pressure can be continuously improved. The GCS score can effectively avoid the occurrence of complications. This method is worthy of application and promotion., 百拇医药(吴秋涛 赵丁丁 冶玉虎 孙兴武 张业斌 张加星 朱车甫 李培兴)