急性重型颅脑损伤行双侧标准大骨瓣术后有创颅内压持续监测对患者神经功能的作用效果分析  

Analysis on the Effect of Continuous Monitoring of Invasive Intracranial Pressure After Bilateral Standard Large Bone Flap on the Neurological Function of Patients with Acute Severe Craniocerebral Injury

作　　者：杨振年 甄云 陈天宝 YANG Zhennian;ZHEN Yun;CHEN Tianbao(Department of Surgery,Nan'ao people's Hospital of Dapeng New District,Shenzhen,Guangdong 518000;Department of Surgery,the Central Hospital of Bao’an District,Shenzhen,Guangdong 518000)

机构地区：[1]深圳市大鹏新区南澳人民医院外科,广东深圳518000 [2]深圳市宝安区中心医院外科,广东深圳518000

出　　处：《智慧健康》2023年第7期133-136,共4页Smart Healthcare

摘　　要：目的 研究急性重型颅脑损伤行双侧标准大骨瓣术后有创颅内压持续监测对患者神经功能的作用效果。方法 纳入宝安中心医院从2015年1月-2017年12月收治的急性重型颅脑损伤患者120例进行研究。将所有受试者按照随机数表法等分成监测组和对照组。对照组仅行双侧标准大骨瓣减压术治疗,监测组则在对照组的基础上用有创颅内压持续监测干预。比较两组治疗前后颅内压、神经功能变化情况,围术期并发症发生情况,预后情况。结果 治疗后监测组及对照组颅内压水平均明显低于治疗前,且监测组显著低于对照组(P<0.05)。治疗后监测组及对照组格拉斯哥昏迷(GCS)评分均明显高于治疗前,且监测组显著高于对照组(P<0.05)。监测组电解质紊乱、感染发生率均显著低于对照组(P<0.05)。监测组预后良好率高于对照组,而死亡率低于对照组(P<0.05)。结论 急性重型颅脑损伤行双侧标准大骨瓣术后有创颅内压持续监测有利于患者的疾病康复,可在一定程度上改善患者预后,值得临床推广应用。Objective To study the effect of continuous monitoring of invasive intracranial pressure(ICP)on nerve function in patients with acute severe craniocerebral injury after bilateral standard large bone flap surgery.Methods 120 patients with acute severe craniocerebral injury admitted to Baoan central hospital from January 2015 to December 2017 were included in the study.All subjects were divided into the monitoring group and the control group according to the random number table.The control group received bilateral standard large bone flap decompression,while the monitoring group received invasive intracranial pressure continuous monitoring intervention on the basis of the control group.The changes of intracranial pressure,nerve function,perioperative complications and prognosis before and after treatment were compared between the two groups.Results The level of intracranial pressure in the monitoring group and control group after treatment was significantly lower than that before treatment,and that in the monitoring group was significantly lower than that in the control group(P<0.05).The Glasgow coma(GCS)score in the monitoring group and control group after treatment was significantly higher than that before treatment,and the GCS score in the monitoring group was significantly higher than that in the control group(P<0.05).The incidence of electrolyte disorder and infection in the monitoring group was significantly lower than that in the control group(P<0.05).The proportion of the patients with good prognosis in the monitoring group was significantly higher than that in the control group,while the proportion of the patients with good prognosis was significantly lower than that in the control group(P<0.05).Conclusion Continuous monitoring of invasive intracranial pressure after bilateral standard large craniocerebral flap surgery for acute severe craniocerebral injury is beneficial to the rehabilitation of patients,and can improve the prognosis of patients to some extent.It is worthy of clinical application.

关 键 词：重型颅脑损伤 双侧标准大骨瓣减压术 有创颅内压监测 神经功能 预后 

分 类 号：R651.15[医药卫生—外科学]