无创颅内压监测在创伤性急性弥漫性脑肿胀治疗中的临床应用研究  

A Clinical Study of Noninvasive Intracranial Pressure Monitoring in the Treatment of Traumatic Acute Diffuse Brain Swelling

作　　者：沈晨[1] 施巍[1] 杨治荣[1] 郭智霖[1] 范其亮 吴祎炜 SHEN Chen;SHI Wei;YANG Zhi-rong;GUO Zhi-lin;FAN Qi-liang;WU Wei-wei(Department of Neurosurgery, Ninth People＇s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China)

机构地区：[1]上海交通大学医学院附属第九人民医院神经外科,上海200011

出　　处：《现代生物医学进展》2018年第8期1494-1497,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨无创颅内压监测(Intracranial pressure,ICP)监测对救治创伤性急性弥漫性脑肿胀(Posttraumatic acute diffuse brains welling,PADBS)患者的辅助作用,为无创ICP检测的临床应用提供参考依据。方法:收集2011年1月至2016年1月我院神经外科收治的114例PADBS患者的临床资料进行回顾性分析,依据纳入与排除标准共取得病例组53例,对照组61例,分别给予采用无创颅内压监测和有创颅内压监测,根据患者资料进行组间比较及生存分析。结果:病例组与对照组不同分型颅内压检测值比较无统计学差异(P>0.05);患者48h内进行大骨瓣开颅手术时间的生存分析,病例组中位手术时间为35.6个月,对照组中位DFS为33.5个月,两组患者检测进行手术时间的生存曲线无统计学差异(P>0.05);有创ICP检测患者继发性出血率为3.2%,脑脊液感染病况为7.9%;两组患者预后情况差异并无统计学意义(P>0.05)。无创ICP检测患者住院天数短于有创ICP检测患者(P<0.05)。结论:无创ICP应用于PADBS治疗的临床价值与有创ICP相当,但无创ICP更便捷、创伤小,有利于对患者进行持续性检测。Objective： To explore the auxiliary effect of non-invasive ICP monitoring on the treatment of PADBS patients and to provide reference for the clinical application of noninvasive ICP detection. Methods： The clinical data of 114 patients with PADBS in our department of neurosurgery from January 2011 to January 2016 were retrospectively analyzed. According to inclusion and exclusion criteria, 53 cases in the case group and 61 cases in the control group were collected. Non-invasive intracranial pressure monitoring and invasive intracranial pressure monitoring were used respectively. Comparison and survival analysis were carried out according to patients＇ data. Results： The patients with intracranial pressure and mean pressure type number, the case group and the control group there was no significant difference between the values of different types of intracranial pressure detection（P〉0.05）; analysis of large bone flap craniotomy in the survival time in patients with 48 h, patients the median operative time was 35.6 months, the control group DFS was 33.5 months. There was no significant difference in survival curve, the operation time was detected in two groups（P〉0.05）; a ICP detection rate of 3.2% patients with secondary hemorrhage, cerebrospinal fluid infection condition was 7.9%; the prognosis of two groups were no significant difference（P〉0.05）. The number of hospitalized patients with noninvasive ICP was shorter than that of invasive ICP（P〈0.05）.Conclusion： The clinical value of non-invasive ICP in the treatment of PADBS is equivalent to that of invasive ICP, but non-invasive ICP is more convenient and less invasive, which is beneficial to the continuous detection of patients.

关 键 词：无创监测 颅内压 创伤性急性弥漫性脑肿胀 

分 类 号：R651[医药卫生—外科学]