颅内压监测在老年颅脑损伤治疗中的疗效观察  

Observation of the effect of intracranial pressure monitoring in the treatment of traumatic brain injury in elderly patients

作　　者：毕永延 徐福林[1] 吴少帅 Bi Yongyan;Xu Fulin;Wu Shaoshuai(Department of Neurosurgery,Minhang Hospital,Fudan University,Minhang,Shanghai,201199,P.R.China)

机构地区：[1]复旦大学附属闵行医院(上海市闵行区中心医院)神经外科,上海201199

出　　处：《老年医学与保健》2023年第4期683-685,689,共4页Geriatrics & Health Care

基　　金：上海市闵行区高层次专科骨干医师培养计划(2020MZYS25);上海市自然科学基金项目(23ZR1455500)。

摘　　要：目的 探讨颅内压(intracranial pressure, ICP)监测在老年颅脑损伤(traumatic brain injury, TBI)治疗中的意义。方法 回顾性分析2019年1月—2021年12月行开颅手术治疗的80例老年TBI的临床资料,采用ICP监测者为观察组,未采用ICP监测者为对照组,每组40例。对照组根据临床经验使用甘露醇等药物进行降ICP治疗;观察组根据ICP监测结果采取降ICP有效措施。结果 术后3个月,观察组预后良好率(72.5%, 29/40;格拉斯哥预后评分量表(GOS)评分4~5分)高于对照组(37.5%, 15/40;P<0.05)。观察组术后再出血、肾功能不全、电解质紊乱及肺部感染等并发症发生率均低于对照组(P<0.05)。结论 老年患者TBI术后持续ICP监测有助于临床及时采取针对性降ICP措施,减少并发症,改善患者预后。Objective To explore the significance of intracranial pressure(ICP)monitoring in the treatment of traumat⁃ic brain injury(TBI)in the elderly.Methods The clinical data of 80 elderly patients with TBI who underwent craniotomy from January 2019 to December 2021 were retrospectively analyzed.The observation group was monitored by ICP,while the control group was not monitored by ICP,with 40 cases in each group.The control group was treated with mannitol and other drugs to reduce ICP according to clinical experience,while the observation group took effective measures to reduce ICP according to ICP monitoring results.Results Three months after operation,the good prognosis rate in the observation group[72.5%,29/40;Glasgow Prognostic Scale(GOS)score 4⁃5 points]was significantly higher than that of control group(37.5%,15/40)(P<0.05).The incidence of complications such as postoperative rebleeding,renal dysfunction,electrolyte disorders,and pul⁃monary infection in the observation group was lower than that in the control group(P<0.05).Conclusion Continuous ICP monitoring after TBI in elderly patients is helpful to take targeted measures to reduce ICP in time,reduce complications and im⁃prove the prognosis of patients.

关 键 词：老年 颅脑损伤 手术治疗 颅内压监测 

分 类 号：R651.15[医药卫生—外科学]