有创颅内压监测下控制性阶梯式减压在重型颅脑损伤中的应用  

Application of Controlled Stepped Decompression under Invasive Intracranial Pressure Monitoring in Severe Craniocerebral Injury

作　　者：严志东[1] 张鹏[1] 赵昆玉 黎海滨[1] 高忠恩[1] 岑庆君[1] 冯荣亮[1] YAN Zhidong;ZHANG Peng;ZHAO Kunyu;LI Haibin;GAO Zhong’en;CEN Qingjun;FENG Rongliang(Zhaoqing First People's Hospital,Zhaoqing 526000,China;不详)

机构地区：[1]肇庆市第一人民医院,广东肇庆526000

出　　处：《中外医学研究》2024年第27期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：肇庆市科技计划项目(2022040308004)。

摘　　要：目的:探讨有创颅内压监测下控制性阶梯式减压法治疗重型颅脑损伤者的应用价值。方法:选取2022年7月—2023年7月肇庆市第一人民医院收治的82例重型颅脑外伤者作为研究对象,将其分为对照组和试验组,每组各41例。患者均未行手术治疗,且处于急性期。对照组常规监测生命体征变化情况,试验组行脑室型有创颅内压监测探头植入术。比较两组颅内压、并发症发生率(迟发血肿、术后脑梗塞)、死亡率、格拉斯哥昏迷评分法(Glasgow Coma Scale,GCS)评分及预后情况。结果:术后6 h、12 h、24 h,对照组颅内压指标高于试验组,差异有统计学意义(P<0.05)。对照组术后并发症发生率高于试验组,差异有统计学意义(P<0.05)。术后24 h、72 h、7 d,两组GCS评分比较,差异无统计学意义(P>0.05)。术后3个月,对照组恢复良好率低于试验组,差异有统计学意义(P<0.05)。结论:有创颅内压监测下控制性阶梯式减压疗法应用于重型颅脑损伤患者中效果理想,可改善患者颅内压指标,降低术后并发症发生率及死亡率,患者可更快恢复意识,改善预后。Objective:To investigate the value of controlled step decompression under invasive intracranial pressure monitoring in the treatment of severe craniocerebral injury.Method:A total of 82 cases of severe craniocerebral injuries treated in Zhaoqing First People's Hospital from July 2022 to July 2023 were selected as the study objects and divided into a control group and an experimental group,with 41 cases in each group.None of the patients underwent surgical treatment and they were all in the acute stage.The changes of vital signs in the control group were monitored,and the invasive intracranial pressure probe was implanted in the experimental group.Intracranial pressure,incidence of complications(delayed hematoma,postoperative cerebral infarction),mortality,Glasgow Coma Scale(GCS)score and prognosis were compared between the two groups.Result:6 h,12 h,24 h after operation,the intracranial pressure index of control group was higher than that of experimental group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in control group was higher than that in experimental group,and the difference was statistically significant(P<0.05).24 h,72 h and 7 d after surgery,there was no significant difference in GCS scores between the two groups(P<0.05).Three months after operation,the good recovery rate of the control group was lower than that of the experimental group,and the difference was statistically significant(P<0.05).Conclusion:Controlled step decompression under invasive intracranial pressure monitoring has an ideal effect in patients with severe craniocerebral injury,which can improve the intracranial pressure index,reduce the incidence of postoperative complications and mortality,recover consciousness faster,and improve prognosis.

关 键 词：重型颅脑损伤 控制性阶梯式减压 有创颅内压监测 并发症 格拉斯哥昏迷评分 预后 

分 类 号：R651.15[医药卫生—外科学]