去骨瓣减压术中持续颅内压监测的意义  

Clinical significance of continuous intracranial pressure monitoring during decompressive craniectomy

作　　者：秦德广 黄文勇[1] 邓略初 杨灵[1] 黄传平[2] 梁英强[1] 罗彦斌[1] 黎伟明[1] 

机构地区：[1]中山市黄圃人民医院神经外科,528429 [2]中国人民解放军第421医院神经外科

出　　处：《临床神经外科杂志》2015年第4期303-305,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨去骨瓣减压术中持续颅内压监测的临床意义。方法对我科2012年1月-2013年12月诊断明确的符合急诊去骨瓣减压手术指征的24例急性重型颅脑创伤患者（治疗组）进行术中全程颅内压监测,根据颅内压的变化,采用逐步控制性减压手术方法。并与同期采用标准外伤大骨瓣减压手术的25例患者（对照组）,比较术中、术后并发症的发生率及对预后的影响。结果治疗组术中、术后并发症的发生率及预后良好率明显优于对照组,两组比较差异有统计学意义（均P〈0.05）。结论去骨瓣减压术中持续颅内压监测,根据颅内压的变化,采用逐步控制性减压手术方法。有助于术中精确控制性减压,减少术中、术后的并发症,术中及时发现问题,指导治疗和评估预后,对改善重型颅脑创伤患者的预后具有一定的临床意义。Objective To explore the clinical significance of continuous intracranial pressure（ ICP） monitoring during decompressive craniectomy（ DC）. Method 24 patients with acute severe cerebral trauma were given DC combined with continuous ICP monitoring from January 2012 to December 2013. According to the changes of intracranial pressure,we used the technique of gradually controlled decompression. Compared with 25 patients underwent standard DC in the control group,without continuous ICP monitoring simultaneously. Intraoperative and postoperative complications and prognosis of the two groups were analyzed. Results The rate of intraoperative and postoperative complications and the good rate of prognosis in the treatment group was better than control group. Differences between the two groups had statistical significance（ all P〈0. 05）. Conclusions Continuous ICP monitoring in DC is helpful to control the decompression precisely,which also reduce the intraoperative and postoperative complications. Due to the ability to find problems intraoperative rapidly,guiding therapy and evaluating prognosis,this technique has a certain clinical significance to improve the efficacy in the cases with severe cerebral trauma.

关 键 词：去骨瓣减压术 术中颅内压监测 重型颅脑创伤 控制减压 

分 类 号：R651.1[医药卫生—外科学]