脑室型颅内压监测在创伤性多发颅内血肿治疗中的应用体会  

Application experience of ventricular intracranial pressure monitoring in the treatment of traumatic multiple intracranial hematoma

作　　者：刘东远[1] 王浩[1] 侯自明[1] 杨俊[1] 王长江[1] 张洪兵[1] Liu Dongyuan;Wang Hao;Hou Ziming;Yang Jun;Wang Changjiang;Zhang Hongbing(Department of Neurosurgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院神经外科,北京101149

出　　处：《中国医师进修杂志》2022年第7期639-642,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨脑室型颅内压监测在创伤性多发颅内血肿(TMIH)治疗中的意义。方法回顾性分析2016年1月至2021年8月首都医科大学附属北京潞河医院14例使用脑室型颅内压监测治疗的TMIH患者的临床资料,患者伤后6个月随访,评估格拉斯哥预后评分(GOS)。结果14例患者均顺利完成脑室型颅内压探头置入术。其中,8例经脑室型颅内压持续监测和持续脑脊液引流治疗后恢复良好,脑室型颅内压探头放置5~10(7.3±2.2)d,均未出现颅内感染,伤后6个月随访GOS均为5分;6例因颅内血肿扩大或水肿加重行开颅血肿清除术,术中均行去骨瓣减压术,伤后6个月GOS 5分3例,4分2例,3分1例。结论TMIH患者病情复杂多变,脑室型颅内压监测可改善TMIH患者的预后。Objective To investigate the significance of ventricular intracranial pressure monitoring in the treatment of traumatic multiple intracranial hematoma(TMIH).Methods The clinical data of 14 TMIH patients treated with ventricular intracranial pressure monitoring from January 2016 to August 2021 in Beijing Luhe Hospital,Capital Medical University were analyzed retrospectively.The patients were followed up 6 months after injury,and the Glasgow outcome score(GOS)was assessed.Results All the 14 patients successfully completed ventricular intracranial pressure probe placement.Among them,8 patients recovered well after continuous monitoring of ventricular intracranial pressure and continuous cerebrospinal fluid drainage.Their ventricular intracranial pressure probe was placed for 5 to 10(7.3±2.2)d,with no intracranial infection occurred;and their GOS was 5 scores 6-month follow-up after injury.Six cases underwent craniotomy for hematoma removal due to the expansion of intracranial hematoma or aggravation of edema,and decompressive craniectomy was performed during the operation;6-month follow-up after injury,GOS of 5 scores was in 3 cases,4 scores in 2 cases,3 scores in 1 case.Conclusions The condition of TMIH patients is complex and changeable,and ventricular intracranial pressure monitoring can improve the prognosis of TMIH patients.

关 键 词：颅内压 颅内出血 创伤性 预后 

分 类 号：R651.15[医药卫生—外科学]