有创颅内压监测对颅脑外伤开颅术的临床价值分析  

Analysis of the clinical value of invasive intracranial pressure monitoring in the treatment of craniotomy for traumatic brain injury

作　　者：梁上男 李成林[1] 叶原森[1] LIANG Shang-nan;LI Cheng-lin;YE Yuan-sen(Department Two of Neurosurgery,Maoming People’s Hospital,Maoming 525000,China)

机构地区：[1]茂名市人民医院神经外二科,525000

出　　处：《中国实用医药》2022年第8期43-46,共4页China Practical Medicine

摘　　要：目的分析颅脑外伤开颅术治疗中进行有创颅内压监测的临床价值。方法64例开展颅脑外伤开颅术的患者,随机分为对照组及实验组,每组32例。对照组患者采用常规颅内压监测,实验组患者采用有创颅内压监测。对比两组不同时间段的颅内压与治疗情况(颅内压探头拔除时间、住院时间)、术中急性脑膨出率与术后并发症发生率。结果术后24 h,实验组颅内压略低于对照组,但差异无统计学意义(P>0.05);术后72、120 h,实验组颅内压分别为(25.10±4.20)、(16.20±3.30)mm Hg(1 mm Hg=0.133 kPa),低于对照组的(27.40±3.60)、(20.80±4.50)mm Hg,差异具有统计学意义(P<0.05);实验组颅内压探头拔除时间(2.47±0.26)d与住院时间(20.01±2.33)d短于对照组的(4.13±1.02)、(30.47±3.68)d,差异具有统计学意义(P<0.05)。实验组术中急性脑膨出率3.13%与术后并发症发生率6.25%低于对照组的18.75%、28.13%,差异具有统计学意义(P<0.05)。结论在颅脑外伤开颅术治疗中采用有创颅内压监测的效果理想,可有效降低颅内压,减少急性脑膨出率,提高预后效果,临床可进一步推广运用。Objective To analyze the clinical value of invasive intracranial pressure monitoring in the treatment of craniotomy for traumatic brain injury.Methods A total of 64 patients with traumatic brain injury who underwent craniotomy were randomly divided into control group and experimental group by drawing lots,with 32 cases in each group.Patients in the control group received conventional intracranial pressure monitoring,while patients in the experimental group received invasive intracranial pressure monitoring.The intracranial pressure and treatment(intracranial pressure probe removal time,hospitalization time),intraoperative acute encephalocele and postoperative complications were compared between the two groups.Results At 24 h postoperatively,the intracranial pressure in the experimental group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).At 72 and 120 h postoperatively,the intracranial pressure in the experimental group were(25.10±4.20)and(16.20±3.30)mm Hg(1 mm Hg=0.133 kPa),which were lower than(27.40±3.60)and(20.80±4.50)mm Hg in the control group,and the differences were statistically significant(P<0.05).The intracranial pressure probe removal time(2.47±0.26)d and hospitalization time(20.01±2.33)d in the experimental group were shorter than(4.13±1.02)and(30.47±3.68)d in the control group,and the difference was statistically significant(P<0.05).The intraoperative acute encephalocele rate 3.13%and postoperative complication rate 6.25%in the experimental group were lower than 18.75%and 28.13%in the control group,and the differences were statistically significant(P<0.05).Conclusion In craniotomy for traumatic brain injury,invasive intracranial pressure monitoring has ideal effect on invasive intracranial pressure monitoring,and it can effectively reduce intracranial pressure and acute encephalocele rate,and improve the prognosis,which can be further promoted and applied in clinic.

关 键 词：颅脑外伤开颅术 有创颅内压监测 颅内压水平 术中急性脑膨出率 

分 类 号：R651.15[医药卫生—外科学]