脑脊液动力学监测在脑积水治疗中的应用研究  

Cerebrospinal fluid dynamics monitoring in the treatment of hydrocephalus

作　　者：钟书[1] 梁有明[1] 肖泉[1] 黄寨[1] 唐秀文[1] 庞刚[1] 蓝胜勇[1] 叶劲[1] 刘若平[1] 杜芸[1] 

机构地区：[1]广西壮族自治区人民医院神经外科,南宁530021

出　　处：《中国临床新医学》2012年第11期1015-1018,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西自然科学基金资助项目(编号:桂科青0640027)

摘　　要：目的通过探讨脑积水后颅内压动态变化的规律,揭示脑积水脑脊液循环动力学改变的生理特点,为分流管选择提供准确简便的指标。方法按随机数字表法将62例脑积水患者随机分为两组,对照组以术前腰穿测定颅内压为基准;实验组采用无创颅内压监测仪持续监测交通性脑积水患者颅内压变化,绘制压力/时间曲线,以平台期初始压力点为基准,选择相应压力的分流管。采用Salmon的脑积水分流术疗效评定标准评估两组患者预后情况。结果术后两组各时点疗效比较差异均无统计学意义(P>0.05),但6个月时点两组好转率比较差异有统计学意义(P<0.05)。结论压力/时间曲线的平台期初始压力可以较准确地判定理想颅内压值,在脑积水的临床治疗中有一定的指导意义。Objective To investigate the intracranial pressure dynamic changes of patients with hydrocephalus, revealing the physiological characteristics of CSF circulation dynamics change of hydrocephalus, to provide accurate and simple indicator for shunt selection. Methods With a non-invasive intracranial pressure monitor, intracranial pressure change was continuously monitored in patients with communicating hydrocephalus, drawing a pres- sure/time curve. In control group, preoperation lumbar cyst pressue were used as base line of intracranial pressure, and in experimental group, critical pressure point of the plateau of the pressure/time curve were used as base line. Selecting of the appropriate pressure of shunt system was based on the base line. The Salmon hydrocephalus shunt evaluation standard was used for assessment of patients＇ prognosis of two groups. Results There were no statistically difference in therapeutic effect at each time point between two groups, but there was statistically significant difference in improvement rate at six month between two groups （P 〈 0.05）. Conclusion The critical pressure point of the plateau of the pressure/time curve can more accurately determine the ideal intracranial pressure value and have significant and wide application prospect in the guidance of the clinical treatment of hydrocephalus.

关 键 词：交通性脑积水 无创颅内压监测 脑室腹腔分流 

分 类 号：R446.14[医药卫生—诊断学]