持续颅内压监测对重型颅脑损伤标准大骨瓣减压术后治疗的影响  

The effect of continuous intracranial pressure monitoring on the treatment of severe craniocerebral injury with standard large cranial flap decompression

作　　者：刘兴海[1] 刘俊[1] 常谦[1] LIU Xinghai;LIU Jun;CHANG Qian(Department of Neurosurgery,Kunming First People＇s Hospital, Kunming 650000, Chin)

机构地区：[1]昆明市第一人民医院神经外科,云南昆明650000

出　　处：《中国实用神经疾病杂志》2018年第9期1003-1006,共4页Chinese Journal of Practical Nervous Diseases

基　　金：云南省卫生科技计划项目;项目编号:2016NS329

摘　　要：目的探讨持续颅内压监测在重型颅脑损伤中的意义。方法选取昆明市第一人民医院神经外科2016-01—2018-01收治的重型颅脑损伤行标准大骨瓣减压术患者51例,按随机数字表法分为观察组和对照组,观察组行联合持续颅内压监测和标准大骨瓣减压术,对照组仅行标准大骨瓣减压术。观察比较2组颅内压、GCS评分和预后情况。结果 2组治疗前颅内压水平无显著差异,治疗后较治疗前均有所下降(P<0.05),观察组治疗后较对照组治疗后,颅内压水平更低(P<0.05)。2组术前GCS评分差异无统计学意义(P>0.05),术后7d较术前均增高(P<0.05),观察组术后7dGCS评分较对照组术前GCS评分更高(P<0.05)。观察组总有效率88.5%,对照组总有效率80.0%,观察组预后优于对照组,差异有统计学意义(P<0.05)。结论持续颅内压监测有利于重型颅脑损伤标准大骨瓣减压术后的治疗。Objective To explore the significance of continuous intracranial pressure monitoring in severe brain injury.Methods 51 patients with severe craniocerebral injury who underwent standard large bone decompression from January 2016 to January 2018 in Kunming First People＇s Hospital Neurosurgery were selected and divided into observation group and control group according to the random number table method.The observation group underwent combined continuous intracranial pressure monitoring with standard large bone flap decompression,and the control group underwent standard large bone flap decompression.We observed and compared intracranial pressure,GCS score and prognosis of the two groups.Results There was no difference in intracranial pressure before treatment between the two groups.After treatment,the intracranial pressure was decreased（P〈0.05）,but the observation group was lower than the control group（P〈0.05）.There was no difference in preoperative GCS scores between the two groups,and it was higher on the 7 th day after operation（P〈0.05）.The GCS score on the 7 th day after surgery in the observation group was higher than the preoperative GCS score in the control group（P〈0.05）.The total effective rate was88.5%in the observation group and 80.0%in the control group.The prognosis in the observation group was better than that in the control group（P 0.05）.Conclusion Continuous intracranial pressure monitoring is beneficial to the treatment of severe craniocerebral injury with standard large cranial flap decompression.

关 键 词：持续颅内压监测 重型颅脑损伤 标准大骨瓣减压术 控制减压 随即对照研究 预后 颅内压 GCS评分 

分 类 号：R651.15[医药卫生—外科学]