持续颅内压监测在双侧额叶脑挫裂伤中的临床应用
|
摘要
目的评估持续颅内压监测在双侧额叶脑挫裂伤中的临床价值。方法选择2016年10月～2018年1月在武汉科技大学附属天佑医院神经外科住院的11例均行颅内压监测的双侧额叶脑挫裂伤患者临床资料进行回顾性分析。所有患者采用保守或手术治疗,同时对患者3个月格拉斯哥恢复评分(GOS)评估预后。结果 3例患者保守治疗;8例行双侧去骨瓣减压术+脑挫伤灶清除术;3个月时进行GOS评估,7例恢复良好,1例中残,1例重残,死亡2例。结论颅内压监测可以为患者保守治疗提供安全保障,同时在患者病情变化时,为我们提供最佳手术时机,从而改善患者预后。
Objective To evaluate the clinical value of continuous intracranial pressure monitoring in bilateral frontal lobe cerebral contusion. Methods Clinical data of 11 patients with bilateral frontal lobe cerebral contusion who were hospitalized and underwent intracranial pressure monitoring in department of neurosurgery of Tianyou Hospital Affiliated to Wuhan University of Science and Technology from October 2016 to January 2018 were retrospectively analyzed.All patients were given conservative or surgical treatment.In addition,Glasgow Outcome Scale(GOS) scores of patients in three months were used to evaluate prognosis. Results 3 patients underwent conservative treatment and 8 patients underwent decompressive craniectomy combined with brain contusion removal.After three months,GOS evaluation showed that there were 7 cases of good recovery,1 case of moderate disability,1 case of severe disability and 2 cases of deaths. Conclusion Intracranial pressure monitoring can provide safe guarantees for patients with conservative treatment and provide us with the best time for surgery when patients' conditions change,so as to improve the prognosis of patients.
Objective To evaluate the clinical value of continuous intracranial pressure monitoring in bilateral frontal lobe cerebral contusion. Methods Clinical data of 11 patients with bilateral frontal lobe cerebral contusion who were hospitalized and underwent intracranial pressure monitoring in department of neurosurgery of Tianyou Hospital Affiliated to Wuhan University of Science and Technology from October 2016 to January 2018 were retrospectively analyzed.All patients were given conservative or surgical treatment.In addition,Glasgow Outcome Scale(GOS) scores of patients in three months were used to evaluate prognosis. Results 3 patients underwent conservative treatment and 8 patients underwent decompressive craniectomy combined with brain contusion removal.After three months,GOS evaluation showed that there were 7 cases of good recovery,1 case of moderate disability,1 case of severe disability and 2 cases of deaths. Conclusion Intracranial pressure monitoring can provide safe guarantees for patients with conservative treatment and provide us with the best time for surgery when patients' conditions change,so as to improve the prognosis of patients.
引文
[1]李建明,李树峰,脑外伤新概念[M],北京:人民卫生出版社,2013,5:13-15
[2]中国医师协会神经外科医师分会、中国神经创伤专家委员会.中国颅脑创伤颅内压监测专家共识[J].中华神经外科杂志,2011,27(10):1073-1074.
[3]Stenger RD,Schmidt S,Beyer B,et al.Use of the glasgow coma scale in pediatric craniocerebral trauma[J].Kinderarztl Prax,2013,61(10):359-364.
[4]Gao L,Wu X,Hu J,et al,Intensive management and prognosis of 127 cases with traumatic bilateral frontal contusions[J].J Craniofac Surg,2012,23(6):1819-1821.
[5]李传玉,黄海能,覃成箭,等.双侧额叶脑挫裂伤的手术指征探讨[J].中华神经创伤外科电子杂志,2016(2):105-107.
[6]高亮,正确评价颅内压监测在重型创伤性颅脑损伤救治中的地位[J],中华创伤杂志,2013,2(29):100-102.
[7]孟庆虎,孟华,丁璇,等.持续颅内压监测在额叶挫裂伤患者治疗中的作用[J].中华神经创伤外科电子杂志,2015(2):17-20.
[8]Dong JR,Cai XJ,Wang B,et al.Intracranial pressure monitoring for special patterns of frontal lobe contusions[J].Chin J Traumatol,2010,13(1):51-54.
[9]邹为,王斌,张晓莉.额叶占位致脑中心疝64例诊治分析[J].实用医院临床杂志,2017(4):211-214.
[10]刘海兵,魏梁锋,王守森,等.双侧额叶脑挫裂伤经单侧开颅显微镜下手术体会[J].中国微侵袭神经外科杂志,2016,21(7):315-316.
[11]谈超,丁明亮,刘红朝.冠状切口双额颞去骨瓣减压术治疗重型额叶脑挫裂伤伴脑内血肿的临床效果分析(附59例报告)[J].神经损伤与功能重建,2017(6):569-571.
[12]周峰,何华,郝东宁,等.显微镜下经额纹入路治疗额叶脑挫裂伤及脑内血肿[J].中华神经外科疾病研究杂志,2016,15(1):79-80.
[13]郑维涛,高强,熊东胜.持续颅内压监护在对冲性双额叶脑挫裂伤救治中的应用[J].中国临床神经外科杂志,2016(5):296-297.
[14]曾上飞,娄晓辉,陈宁,等.持续颅内压监测在双额叶脑挫裂伤致中央型脑疝患者中的应用价值[J].浙江医学,2016,38(9):627-629.
[15]徐亦农,周劲旭,张闻闻,等.脑室型颅内压监测在双额底脑挫裂伤患者治疗中的应用[J].江苏医药,2016,42(4):411-413.
[16]吴雪海,高亮,胡锦,等.颅内压监测指导双额脑挫裂伤高冠状开颅脑挫裂伤清除术79例[J].中华创伤杂志,2013,29(2):103-106.
[2]中国医师协会神经外科医师分会、中国神经创伤专家委员会.中国颅脑创伤颅内压监测专家共识[J].中华神经外科杂志,2011,27(10):1073-1074.
[3]Stenger RD,Schmidt S,Beyer B,et al.Use of the glasgow coma scale in pediatric craniocerebral trauma[J].Kinderarztl Prax,2013,61(10):359-364.
[4]Gao L,Wu X,Hu J,et al,Intensive management and prognosis of 127 cases with traumatic bilateral frontal contusions[J].J Craniofac Surg,2012,23(6):1819-1821.
[5]李传玉,黄海能,覃成箭,等.双侧额叶脑挫裂伤的手术指征探讨[J].中华神经创伤外科电子杂志,2016(2):105-107.
[6]高亮,正确评价颅内压监测在重型创伤性颅脑损伤救治中的地位[J],中华创伤杂志,2013,2(29):100-102.
[7]孟庆虎,孟华,丁璇,等.持续颅内压监测在额叶挫裂伤患者治疗中的作用[J].中华神经创伤外科电子杂志,2015(2):17-20.
[8]Dong JR,Cai XJ,Wang B,et al.Intracranial pressure monitoring for special patterns of frontal lobe contusions[J].Chin J Traumatol,2010,13(1):51-54.
[9]邹为,王斌,张晓莉.额叶占位致脑中心疝64例诊治分析[J].实用医院临床杂志,2017(4):211-214.
[10]刘海兵,魏梁锋,王守森,等.双侧额叶脑挫裂伤经单侧开颅显微镜下手术体会[J].中国微侵袭神经外科杂志,2016,21(7):315-316.
[11]谈超,丁明亮,刘红朝.冠状切口双额颞去骨瓣减压术治疗重型额叶脑挫裂伤伴脑内血肿的临床效果分析(附59例报告)[J].神经损伤与功能重建,2017(6):569-571.
[12]周峰,何华,郝东宁,等.显微镜下经额纹入路治疗额叶脑挫裂伤及脑内血肿[J].中华神经外科疾病研究杂志,2016,15(1):79-80.
[13]郑维涛,高强,熊东胜.持续颅内压监护在对冲性双额叶脑挫裂伤救治中的应用[J].中国临床神经外科杂志,2016(5):296-297.
[14]曾上飞,娄晓辉,陈宁,等.持续颅内压监测在双额叶脑挫裂伤致中央型脑疝患者中的应用价值[J].浙江医学,2016,38(9):627-629.
[15]徐亦农,周劲旭,张闻闻,等.脑室型颅内压监测在双额底脑挫裂伤患者治疗中的应用[J].江苏医药,2016,42(4):411-413.
[16]吴雪海,高亮,胡锦,等.颅内压监测指导双额脑挫裂伤高冠状开颅脑挫裂伤清除术79例[J].中华创伤杂志,2013,29(2):103-106.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |