对神经外科危重症患者实施持续有创颅内压监测的意义  

Application of sustained invasive ICP monitoring in patients with severe neurological disease

作　　者：权哲[1,2,3] 李志强[1,2,3] 戴新连[1,2,3] 沈冬青[1,2,3] 马勃[1,2,3] 刘宏炜[1,2,3] 张宁[1,2,3] 

机构地区：[1]上海交通大学附属第六人民医院南院 [2]上海市奉贤区中心医院 [3]安徽理工大学上海神经病学研究所,上海201400

出　　处：《山东医药》2013年第47期15-17,共3页Shandong Medical Journal

基　　金：上海市卫生局青年课题资助项目(20124Y140)

摘　　要：目的观察持续有创颅内压(ICP)监测用于神经外科危重症患者诊治的临床价值。方法回顾性分析505例神经外科危重症患者的的临床资料,比较260例行有创ICP监测(监测组)和245例未行有创ICP监测者(对照组)的并发症发生情况和格拉斯哥预后评分(GOS)。结果两组病因、影像学表现和临床表现相似,但监测组电解质紊乱和肾功能异常发生率明显低于对照组,P均<0.01(χ2值分别为43.03、30.95);监测组轻残率显著高于对照组(P<0.05)、重残率显著低于对照组(P<0.01)。结论对神经外科危重症患者进行持续有创ICP监测,能够及时、准确了解ICP变化并指导临床诊治,从而改善患者预后。Objective To explore the clinical value of application of sustained invasive intracranial pressure （IPC） monitoring in patients with severe neurological disease. Methods The clinical data of 505 cases of patients with severe neurological disease, including 260 patients undergoing invasive IPC monitoring （monitoring group） and 245 patients who didnt undergo invasive IPC monitoring （control group）, were retrospectively analyzed. The complications and Glasgow Out come Scale （GOS） in two groups were compared. Results The etiology, imaging findings and clinical manifestations of the two groups were similar, while patients in the monitoring group had fewer complications of renal insufficiency and abnor mality of electrolyte balance as compared with those of the control group 0（2 =43.03, 30.95 respectively; all P 〈0.01 ） ; the mild disability rate was significantly higher in the monitoring group than that in the control group （ P 〈 0.05 ）, but the severe disability rate was significantly lower than that of the control group （ P 〈 0.01 ）. Conclusion The sustained inva sive ICP monitoring can timely and accurately observe ICP changes and guide its clinical diagnosis and treatment, so as to improve the prognosis of patients with severe neurologieal disease.

关 键 词：神经疾病 危重症 颅内压监测 预后 

分 类 号：R651.1[医药卫生—外科学]