脑室内颅内压监测在重型颅脑损伤患者围术期的应用研究  

Study on the application of intraventricular intracranial pressure monitoring in perioperative period of patients with severe craniocerebral injury

作　　者：陈晨[1] 徐宏[1] 李政[1] 韩杨云[1] Chen Chen;Xu Hong;Li Zheng;Han Yangyun(Department of Neurosurgery,Deyang People’s Hospital,Deyang 618000,China)

机构地区：[1]德阳市人民医院神经外科,四川德阳618000

出　　处：《中华脑科疾病与康复杂志（电子版）》2022年第3期146-151,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探究脑室内颅内压监测在重型颅脑损伤患者围术期的作用。方法选取德阳市人民医院神经外科自2019年1月至2020年8月收治的112例重型颅脑损伤患者,按照随机数字表法分为观察组与常规组,每组56例。常规组给予常规干预,观察组在常规组的基础上增加脑室内颅内压监测和调节。对比2组患者的手术时间,出血量,术后甘露醇使用剂量和使用时间,术前与术后1个月神经功能缺损评分,术后1个月内并发症发生情况,以及预后效果。结果2组患者的手术时间和出血量比较,差异均无统计学意义(P>0.05)。观察组术后甘露醇使用剂量少于常规组,使用时间短于常规组,差异均具有统计学意义(P<0.05)。2组患者术后1个月神经功能缺损评分均较术前降低,且观察组低于常规组,差异均具有统计学意义(P<0.05)。观察组术后1个月内各并发症发生率与常规组相比,差异均无统计学意义(P>0.05),观察组总并发症发生率低于常规组,差异具有统计学意义(P<0.05);2组患者的预后效果分布差异具有统计学意义(P<0.05),且观察组预后不良率低于常规组(P<0.05)。结论对重型颅脑损伤患者采用脑室内颅内压监测能减少甘露醇使用,减轻神经功能缺损,降低术后1个月内并发症总发生率,预后效果好。Objective To explore the effect of intraventricular intracranial pressure monitoring in patients with severe craniocerebral injury during perioperative period.Methods One hundred and twelve patients with severe craniocerebral injury treated in the Neurosurgery Department of Deyang Peoples Hospital from January 2019 to August 2020 were divided into observation group and conventional group by a randm digital table,with 56 cases in each group.The observation group was given routine intervention,while the observation group was given intraventricular intracranial pressure monitoring and regulation on the basis of the conventional group.The operation time,blood loss and dosage of mannitol and use time after operation,neurological deficit scores before and 1 month after operation,complications within 1 month after operation,and prognosis were compared between the two groups.Results There were no significant differences in the operation time and blood loss between the two groups(P>0.05).The dosage of mannitol in the observation group was less than that in the conventional group(P<0.05),and the use time was shorter than that in the conventional group(P<0.05).The scores of neurological deficit in the two groups were decreased one month after operation(P<0.05),and the observation group was lower than the conventional group(P<0.05).There was no significant difference in the rates of complications between the observation group and the conventional group within one month after operation(P>0.05),but the total complications rate of the observation group was lower than that in the conventional group(P<0.05).The difference in the distribution of prognosis effect between the two groups was statistically significant(P<0.05),and the poor prognosis rate in the observation group was lower than that in the conventional group(P<0.05).Conclusion Intraventricular intracranial pressure monitoring in patients with severe craniocerebral injury can reduce the use of mannitol,reduce the neurological deficit,reduce the total incidence of complic

关 键 词：脑室内颅内压监测 重型颅脑损伤 神经功能缺损 预后 

分 类 号：R651.15[医药卫生—外科学]