经侧脑室引流管测压与有创颅内压监测的对比研究  

A comparative study on the intracranial pressure monitoring through external ventricular drainage catheter and invasive sensor

作　　者：方文华[1] 许雅纹 蔡嘉伟 王芳玉[1] 林章雅[1] 林元相[1] 康德智[1] Fang Wenhua;Xu Yawen;Cai Jiawei;Wang Fangyu;Lin Zhangya;Lin Yuanxiang;Kang Dezhi(Department of Neurosurgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院神经外科,福州350005

出　　处：《中华神经创伤外科电子杂志》2020年第2期86-90,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：福建省科技计划引导性项目(2017Y0032);福建医科大学启航基金项目(2016QH060)。

摘　　要：目的探讨经侧脑室引流管测压进行实时颅内压(ICP)监测的准确性和安全性。方法对福建医科大学附属第一医院神经外科自2016年1月至2018年6月收治的行脑室型有创ICP监测传感器置入术的28例患者,同时采用压力传感器连接侧脑室外引流管测量脑脊液传导压力(P1),通过临床监测数据采集软件系统每分钟实时采集P1和同期监测的有创ICP数据,每频段连续采集30 min,分析和对比2组数据的一致性。同时对患者的临床特征、颅内感染和浅表手术切口感染、颅内再出血等进行分析。结果28例患者共获得87个频段和2610对P1和ICP数值。有创ICP监测的平均值为(14.217±6.729)mmHg(1 mmHg=0.133 kPa),引流管测压P1的平均值为(14.263±6.765)mmHg,ICP与P1的组内相关系数(ICC)为0.977(P<0.001),具有较高的一致性。2组数据Band-Altman散点图显示P1与ICP的差值为(0.046±1.435)mmHg(95%CI:-2.767~2.859)。28例患者均未发生手术相关的颅内感染、浅表手术切口感染和愈合不良、颅内再出血等。结论经侧脑室引流管连接压力传感器测压与有创ICP传感器监测所得到的ICP值具有良好的一致性,其准确性和安全性较高,可作为持续监测ICP的有效技术。Objective To explore the feasibility and safety of real-time intracranial pressure(ICP)monitoring through the external ventricular drainage catheter.Methods Twenty-eight patients admitted to neurosurgery department in our hospital from January 2016 to June 2018 were enrolled in this study.The cerebro-spinal fluid conduction pressure(P1)was measured by a pressure sensor connected with the external ventricular drainage catheter,and the ICP data was measured by the invasive sensor at the same time.The real-time data of P1 and the ICP in the same period were collected by acquisition software system every minute.Then the data were collected continuously for 30 min in each section for analysis.The consistency of P1 and the ICP were analyzed and compared.The clinical characteristics,the incidence of intracranial infection,superficial surgical incision infection and intracranial rebleeding were analyzed.Results Twenty-eight patients were simultaneously monitored by pressure sensor connected with external ventricular drainage catheter and invasive ICP sensor.Eighty-seven section data and 2610 pairs of pressure values were obtained.The mean value of ICP was(14.217±6.729)mmHg(1 mmHg=0.133 kPa),while the mean value of P1 was(14.263±6.765)mmHg.The intraclass correlation coefficient(ICC)between P1 and ICP was 0.977(P<0.001),suggesting high consistency of two groups of data.The difference between P1 and ICP was(0.046±1.435)mmHg(95%CI:-2.767-2.859).There were no operation-related intracranial infection,poor healing and incision infection, intracranial rebleeding between two data groups. Conclusion The pressure monitoring through external ventricular drainage catheter is highly consistent with invasive ICP sensor, with high accuracy and safety. This method may be used as an effective technique for continuous ICP monitoring.

关 键 词：颅内压监测 脑室外引流 压力传感器 

分 类 号：R651.1[医药卫生—外科学]