重型颅脑损伤患者术后头颅CT环池分级与无创颅内压及脑脊液乳酸的相关性分析  

Analysis of the Correlation between Postoperative CT Cistern Grading and Non-invasive Intracranial Pressure and Cerebrospinal Fluid Lactate in Patients with Severe Traumatic Brain Injury

作　　者：孙峻峰[1] 高强[1] 常蒲英 SUN Junfeng;GAO Qiang;CHANG Puying(The People's Hospital of Baoji,Baoji Shaanxi 721000)

机构地区：[1]宝鸡市人民医院,陕西宝鸡721000 [2]渭南市中心医院,陕西渭南714000

出　　处：《医学临床研究》2023年第11期1683-1686,共4页Journal of Clinical Research

摘　　要：【目的】探讨重型颅脑损伤患者术后头颅CT环池分级与无创颅内压(NICP)及脑脊液乳酸的关系。【方法】选取2019年10月至2022年10月宝鸡市人民医院收治的128例重型颅脑损伤患者,依据患者头颅CT术前环池分级将其分为Ⅰ级组(n=61)、Ⅱ级组(n=46)、Ⅲ级组(n=21)。比较不同分级组患者的颅内压、脑脊液乳酸差异,并采用Spearman相关分析头颅CT环池分级与无创颅内压、脑脊液乳酸的相关性。【结果】术前不同CT环池分级患者术后4 h、术后72 h的CT环池分级情况比较,差异均有统计学意义(P<0.001);Ⅱ级组、Ⅲ级组患者术后4 h、术后72 h的CT环池分级呈下降趋势(均P<0.05)。术后4 h、术后72 h,不同环池分级患者的NICP均低于术前(P<0.05);术后4 h、术后72 h,Ⅱ级组、Ⅲ级组NICP均低于Ⅰ级组,Ⅲ级组低于Ⅱ级组(P<0.05)。术后4 h、术后72 h,不同环池分级患者的脑脊液乳酸水平均低于术前(P<0.05);术后4 h、术后72 h,Ⅱ级组、Ⅲ级组脑脊液乳酸水平均低于Ⅰ级组(P<0.05)。头颅CT环池分级与术后NICP均呈负相关(P<0.05);术前头颅CT环池分级与术前、术后72 h脑脊液乳酸水平均呈负相关(P<0.05);术后4 h环池分级仅与术后72 h脑脊液乳酸水平呈负相关(P<0.01);术后72 h环池分级与术前、术后72 h脑脊液乳酸水平呈负相关(P<0.01)。【结论】重型颅脑损伤患者术前评估CT环池分级能够反映术后NICP水平,且与术前脑脊液乳酸水平密切相关。【Objective】To explore the relationship between postoperative CT cistern grading,non-invasive intracranial pressure(NICP),and cerebrospinal fluid lactate in patients with severe head injury.【Methods】A total of 128 patients with severe traumatic brain injury admitted to Baoji People's Hospital from October 2019 to October 2022 were selected and divided into gradeⅠgroup(n=61),gradeⅡgroup(n=46),and gradeⅢgroup(n=21)based on the preoperative circumferential pool grading of the patient's head CT.We compared the differences in intracranial pressure and cerebrospinal fluid lactate levels among patients with different grades,and used Spearman correlation analysis to investigate the correlation between head CT ring pool grading and non-invasive intracranial pressure and cerebrospinal fluid lactate levels.【Results】There was a statistically significant difference in CT annulus grading between patients with different preoperative CT annulus grading at 4 hours and 72 hours after surgery(P<0.001);The CT annular pool grading of patients in the ClassⅡandⅢgroups showed a decreasing trend at 4 hours and 72 hours after surgery(both P<0.05).At 4 hours and 72 hours after surgery,the NICP of patients with different ring pool grades was lower than before surgery(P<0.05);At 4 hours and 72 hours after surgery,the NICP levels in the gradeⅡandⅢgroups were lower than those in the gradeⅠgroup,while the NICP levels in the gradeⅢgroup were lower than those in the gradeⅡgroup(P<0.05).At 4 hours and 72 hours after surgery,the cerebrospinal fluid lactate levels in patients with different cistern grading were lower than before surgery(P<0.05);At 4 hours and 72 hours after surgery,the cerebrospinal fluid lactate levels in the gradeⅡandⅢgroups were lower than those in the gradeⅠgroup(P<0.05).There was a negative correlation between the grading of the cranial CT annulus and postoperative NICP(P<0.05);There was a negative correlation between preoperative CT cistern grading and cerebrospinal fluid lactate levels bot

关 键 词：颅脑损伤/外科学 体层摄影术 X线计算机 颅内压 乳酸/脑脊髓液 

分 类 号：R651.15[医药卫生—外科学]