有创颅内压监测在重型颅脑损伤手术患者中的应用  

作　　者：张锦贤[1] 陈丽青[1] 郭雷光 

机构地区：[1]浙江省浦江县人民医院,322200

出　　处：《浙江临床医学》2023年第6期881-883,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨有创颅内压监测在重型颅脑损伤手术患者中的应用价值。方法选取2020年5月至2022年5月本院收治的100例重型颅脑损伤患者,依据术中是否进行有创颅内压监测分为观察组(有创颅内压监测50例)与对照组(常规治疗50例)。比较两组手术前后颅内压水平、格拉斯哥昏迷指数评分(GCS)、卡氏功能状态评分标准(KPS),比较两组脱水剂应用情况、住院天数、预后情况、术后并发症情况。结果两组术后1 d、3 d、7 d的颅内压水平显著低于术前,观察组术后3 d、7 d的颅内压水平显著低于对照组(P<0.05);观察组脱水剂应用时间、应用剂量、住院天数均显著少于对照组(P<0.05);两组术后GCS评分、KPS评分显著高于术前,观察组高于对照组(P<0.05);观察组预后良好率为68.00%,显著高于对照组(48.00%)(P<0.05);观察组电解质紊乱发生率显著低于对照组(P<0.05)。结论有创颅内压监测可动态反映重型颅脑损伤手术患者的颅内压水平,及时调整治疗方案,有效改善患者的预后。Objective To investigate the application value of invasive intracranial pressure monitoring in patients with severe craniocerebral injury.Methods A total of 100 patients with severe craniocerebral injury admitted to our hospital from May 2020 to May 2022 were selected and divided into the observation group(invasive intracranial pressure monitoring,50 cases)and control group(conventional treatment,50 cases)according to whether invasive intracranial pressure monitoring was performed intraoperatively.Intracranial pressure levels,Glasgow Coma Index score(GCS),Karnofsky Performance Score(KPS)before and after operation were compared between the two groups.The application of dehydrating agent,length of stay,prognosis and postoperative complications were compared between the two groups.Results The level of intracranial pressure 1 d,3 d and 7 d after surgery was significantly lower than that before surgery,and the level of intracranial pressure 3 d and 7 d after surgery in the observation group was significantly lower than that in the control group(P<0.05).The application time,dosage and hospitalization days of dehydrating agent in observation group were significantly less than those in control group(P<0.05).The postoperative GCS score and KPS score of the two groups were significantly higher than those before surgery,and the observation group was higher than the control group(P<0.05).The good prognosis rate of observation group was 68.00%,which was significantly higher than that of control group(48.00%)(P<0.05).The incidence of electrolyte disturbance in observation group was significantly lower than that in control group(P<0.05).Conclusion Invasive intracranial pressure monitoring can dynamically reflect the level of intracranial pressure in patients undergoing severe craniocerebral injury surgery,timely adjust the treatment plan,and effectively improve the prognosis of patients.

关 键 词：有创颅内压监测 重型颅脑损伤 手术 颅内压 预后 并发症 

分 类 号：R651.15[医药卫生—外科学]