颅内压监测联合标准大骨瓣减压术在老年人颅脑损伤中的应用价值  

Application Value of Intracranial Pressure Monitoring Combined with Standard Large Trauma Craniotomy in Elderly Patients with Craniocerebral Injury

作　　者：林文清 周沂 LIN Wen-qing;ZHOU Yi(The First Affiliated Hospital of Fujian Medical University,Fujian Fuzhou 350000)

机构地区：[1]福建医科大学附属第一医院,福建福州350000

出　　处：《深圳中西医结合杂志》2021年第24期32-34,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:分析颅内压(ICP)监测联合标准大骨瓣减压术治疗老年颅脑损伤患者的效果。方法:选取福建医科大学附属第一医院2019年1月至2020年12月收治的老年颅脑损伤患者80例,根据是否进行ICP监测分为观察组(42例)、对照组(38例)。对照组行标准大骨瓣减压术,观察组在标准大骨瓣减压术基础上实施ICP监测,比较两组患者手术前后颅内压、昏迷程度〔格拉斯哥昏迷量表(GCS)评分〕、预后情况〔格拉斯哥预后量表(GOS)评分〕、术后并发症发生情况。结果:术后3 d、术后7 d,观察组患者ICP值均较对照组更低,差异具有统计学意义(P<0.05);术后2周、术后4周,观察组患者GCS评分均较对照组更高,差异具有统计学意义(P<0.05);术后3个月观察组预后情况优于对照组,差异具有统计学意义(U=2.336,P<0.05);两组患者迟发性血肿、癫痫、脑积水、硬膜下积液、肺部感染等发生率比较无明显差异(P>0.05),观察组患者电解质紊乱发生率较对照组低,差异具有统计学意义(P<0.05)。结论:ICP监测联合标准大骨瓣减压术治疗老年颅脑损伤患者可有效降低ICP值,改善患者预后,减少术后并发症,对指导临床进行综合性治疗有重要价值。Objective To analyze the effect of ICP monitoring combined with standard large trauma craniotomy on elderly patients with craniocerebral injury.Methods 80 elderly patients with craniocerebral injury admitted into the First Affiliated Hospital of Fujian Medical University from January 2019 to December 2020 were selected and divided into the observation group(42 cases)and the control group(38 cases).The control group received standard large trauma craniotomy,and the observation group received ICP monitoring on the basis of standard large trauma craniotomy.The two groups were compared in preoperative and postoperative ICP,coma degree[Glasgow coma scale(GCS)score],prognosis[Glasgow outcome scale(GOS)score]and postoperative complications.Results 3 and 7 days after operation,the ICP values of the observation group were lower than those of the control group(P<0.05);2 and 4 Weeks after operation,all the GCS scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);3 months after operation,the prognosis of the observation group was better than that of the control group,and the difference was statistically significant(U=2.336,P<0.05).There was no significant difference between the two groups in terms of the incidences of delayed hematoma,epilepsy,hydrocephalus,subdural effusion,and pulmonary infection(P>0.05).The incidence of electrolyte disturbance in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion ICP monitoring and standard large trauma craniotomy have exact effects in treating elderly patients with craniocerebral injury.It can effectively reduce the ICP value,improve prognosis and reduce postoperative complications.It is of important value to guiding comprehensive treatment clinically.

关 键 词：颅脑损伤 标准大骨瓣减压术 颅内压监测 老年人 

分 类 号：R651.15[医药卫生—外科学]