微创颅内压监测在重型颅脑外伤治疗中的应用  

Curative Efficacy of Minimally Invasive Intracranial Pressure Monitoring Probe in Implantation of Heavy Head Trauma

作　　者：周海[1] 滕宏伟[1] 周静[1] 仇劲松[1] ZHOU Hai;TENG Hong-wei;ZHOU Jing(Binhai County people＇s Hospital of Jiangsu Province,Jiangsu Binhai,22450)

机构地区：[1]江苏省滨海县人民医院神经外科,江苏滨海224500

出　　处：《医学临床研究》2018年第9期1686-1689,共4页Journal of Clinical Research

摘　　要：【目的】探讨微创植入监测探头监测颅内压（ICP）在重型颅脑外伤治疗中的应用价值。【方法】回顾性分析本院收治的40例重型颅脑外伤患者的临床资料，根据ICP监测方法的不同，将其分为观察组（采用微创植入监测探头）和对照组（常规全麻钻孔植入监测探头），每组各20例。根据监测结果给予患者相应的治疗，治疗后进行为期1年的临床结局，比较两组患者格拉斯哥预后评分（GOS）、神经功能评分（NIHSS）、并发症情况及死亡情况。【结果】观察组手术用时、术中出血量分别为（13．47±3．58）min、（65．21±6．1i）mL显著低于对照组的（36．68±2．62）min、（97．43±12．63）mL，差异具有统计学意义（P〈0．05）。治疗前，两组GOS、NIHss评分比较，差异无统计学意义（P〉0．05）；治疗后，两组GOS评分高于治疗前，但观察组显著高于对照组，差异具有统计学意义（P〈0．05）；两组患者NIHSS评分低于治疗前，观察组NIHSS评分显著低于对照组，差异具有统计学意义（P〈0．05）。观察组并发症发生率为25．00％（5／20）显著低于对照组的60．00％（12／20），差异具有统计学意义（χ^2=5．013，P=0．025〈0．05）。观察组患者总死亡率20．00％（4／20）显著低于对照组50．00％（10／20），差异具有统计学意义（χ^2=6．241，P=0．013＜0．05）。【结论】重型颅脑外伤患者的治疗中采用微创法颅内压探头植入可同样准确监测患者颅内压，且具有减少手术时间，减少创伤，操作简单、并发症少等优点，还可改善患者预后，降低死亡率，值得临床应用推广。[ObjectivelTo study the curative efficacy of minimally invasive intracranial pressure monitoring probe in implantation of severe craniocerebral trauma and its significance. [Methods]The clinical data of 40 patients with severe craniocerebral trauma treated in our hospital were retrospectively analyzed. According to the different monitoring methods of ICP, It was divided into observation group （with minimally invasive implant probe） and control group （routine general anesthesia borehole implantation monitoring probe） with 20 cases in each group.According to the monitoring results, the patients were given corresponding treatment and followed up for a period of one year after the treatment. Glasgow prognosis score （GOS）, NIHSS, complications and death were compared between the two groups. [Results]In the observation group, the operation time and intraoperative bleeding volume were （13.47 ±3.58） rain, （65.21±6.11） mL,significantly lower than those in the control group （36.68 ±2.62） min, （97.43±12.63） mL, the difference was statistically significant （P〈0.05）. Before treatment, there was no significant difference in GOS, NIHSS score between the two groups （P 〉 0.05）. After treatment, the GOS score of the two groups was higher than that before treatment ,and the observation group was higher than the control group, the difference was statistically significant （P〈0.05）. The NIHSS score of the two groups was lower than that before treatment（P〈0.05）. The NIHSS score in the observation group was significantly lower than that in the control group, the difference was statistically significant （ P〈0.05）.The incidence of complications in the observation group was 25.00% （5 / 20）, which was signifi- cantly lower than that in the control group （60.00 %, 12 / 20）. The difference was statistically significant（χ^2 = 5.013, P = 0.025〈0.05）. The total mortality of patients in the observation group was 20.00 %4 / 20） which was significantly lower than that in

关 键 词：颅脑损伤 危重病 颅内压 

分 类 号：R651.15[医药卫生—外科学]