持续颅内压监测在双额叶脑挫裂伤致中央型脑疝患者中的应用价值  

Application of continuous intracranial pressure monitoring in treatment of patients with central hernia caused by dual frontal lobe contusion

作　　者：曾上飞[1] 娄晓辉[1] 陈宁[1] 蒋聚洪[1] 

机构地区：[1]温州医科大学附属第三医院神经外科,瑞安325200

出　　处：《浙江医学》2016年第9期627-629,共3页Zhejiang Medical Journal

摘　　要：目的探讨持续颅内压监测在双额叶脑挫裂伤致中央型脑疝患者中的应用价值。方法选取2010年1月至2014年2月期间63例双额叶脑挫裂伤后并发中央型脑疝患者,剔除手术患者后,分为对照组25例和监测组27例,比较分析两组患者脱水剂使用情况、住院时间、治疗后6个月的预后情况(GOS评价)和并发症发生情况。结果与对照组比较,监测组患者甘露醇使用时间和住院时间明显缩短,甘露醇使用量明显减少,差异均有统计学意义(均P<0.05);监测组患者治疗6个月后GOS评价为良好者占比明显提高,达70.73%,病死率明显降低,仅为3.70%,差异均有统计学意义(均P<0.05);监测组患者肝功能损害和电解质紊乱的发生率明显降低,仅为7.41%和14.81%,差异均有统计学意义(均P<0.05)。结论持续颅内压监测能够指导临床合理用药,对降低药物不良反应的发生,改善双额叶脑挫裂伤致中央型脑疝患者的预后有重要的应用价值。Objective To assess the application of continuous intracranial pressure monitoring in treatment of patients with central hernia caused by dual frontal lobe contusion. Methods Sixty three patients with central hernia caused by dual frontal lobe contusion admitted in our hospital from January 2010 to February 2014 were enrolled in the study. The patients were assigned to control group （n=25） and monitoring group （n=27） randomly. The prognosis of six months after treatment （GOS evaluation）, the incidence of postoperative complications, the dosage and time of dehydrating agents and length of hospital stay of the patients in two groups were compared and analyzed. Results Compared with control group, the GOS well rate of six months after treatment, in monitoring group was significantly higher （70.73%）, the death rate was lower （3.70%） （P〈0.05）. Compared with control group, the incidence of renal dysfunction and postoperative electrolyte imbalance in monitoring group were significantly lower （7.41% and 14.81%, respectively; P〈0.05）. Compared with control group, the time and dosage of mannitol use was reduced and length of hospital stay in monitoring group was shorted significantly （P〈0.05）. Conclusion Continuous intracranial pressure monitoring can guide rational drug use, reduce the incidence of adverse drug reactions and improve the prognosis of patients with central hernia caused by dual frontal lobe contusion.

关 键 词：中央型脑疝 双额叶脑挫裂伤 持续颅内压监测 应用价值 

分 类 号：R651.15[医药卫生—外科学]