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有创颅内压监测在重型颅脑损伤患者术后治疗中的价值 认领 被引量:25

The value of invasive intracranial pressure monitoring for postoperative treatment of patients with severe craniocerebral injury
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摘要 目的探讨有创颅内压监测在重型颅脑损伤患者术后治疗中的临床应用价值。方法选择2011年3月至2014年3月在武警浙江总队杭州医院进行诊治的74例重型颅脑损伤患者作为研究对象,所有患者术后均行颅内压监测,并分为观察组和对照组各37例。观察组采用Codman颅内压监护仪进行有创颅内压监测,对照组采用闪光视觉诱发电位进行无创颅内压监测。依据所测颅内压的动态变化调整甘露醇使用剂量及时间,必要时复查头颅CT检查并行相应处置。结果观察组术后72、120h颅内压水平低于对照组,差异有统计学意义(t=-2.39、-5.41,P〈0.05)。观察组甘露醇平均应用时间及剂量低于对照组,差异有统计学意义(t=-18.80、-22.50,P〈0.05)。观察组格拉斯哥预后评分(GOS评分)预后良好的比例高于对照组,差异无统计学意义(χ^2=0.216,P〉0.05)。结论有创颅内压监测能准确反映重型颅脑损伤患者术后颅内压变化情况,有助于指导临床用药。 Objective To investigate the value of invasive intracranial pressure monitoring for postoperative treatment of patients with severe craniocerebral injury.Methods From March 2011 to March 2014,74 patients with severe craniocerebral injury in our hospital were enrolled in this analysis.All patients were randomly divided into the observation group and the control group,37 cases in each group and underwent intracranial pressure monitoring.Then the observation group and control group were respectively treated by Codman intracranial monitoring probe with invasive intracranial pressure monitoring,and flash visual evoked potential(FVEP)with noninvasive intracranial pressure monitoring.Based on the dynamic changes of the measured intracranial pressure,and we should timely adjust the dose and time of mannitol,and reviewed CT if necessary.Results The intracranial pressures of the observation group at 72,120 hafter the operation were lower than control group(t=-2.39,-5.41,P〈0.05).The mean dose and application time of the observation group was lower than control group(t=-18.80,-22.50,P〈0.05).The GOS score of observation group were higher than the control group(χ^2=0.216,P〉0.05).Conclusion Invasive intracranial pressure monitoring probe can more accurately reflect the changes of intracranial pressure in patients with severe craniocerebral injury after the operation,and help to guide clinical treatment.
作者 方黎晓 胡少玄 徐洪飞 范龙龙 谈航 姜菲 FANG Lixiao,HU Shaoxuan,XU Hongfei,FAN Longlong,TAN Hang,JIANG Fei(Department of Neurosurgery, Hangzhou Hospital of Zhejiang Armed Police Corps, Hangzhou,Zhejiang 310051 ,China)
出处 《检验医学与临床》 CAS 2016年第12期1631-1632,1635共3页 Laboratory Medicine and Clinic
关键词 重型颅脑损伤 有创颅内压监测 闪光视觉诱发电位 severe traumatic brain injury invasive intracranial pressure monitoring flash visual evoked potentials
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