颅内压持续监护在重型颅脑损伤患者术后治疗中的应用效果
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摘要
目的探讨颅内压持续监护在重型颅脑损伤患者术后治疗中的应用效果。方法选取2016年12月～2018年12月我院收治的96例重型颅脑损伤患者作为研究对象,按照随机抽签法分为对照组(48例)与观察组(48例)。对照组采用常规神经外科治疗,观察组采用常规联合颅内压持续监护治疗。比较两组的治疗效果、脱水剂剂量、应用时间及并发症总发生率。结果观察组的良好率高于对照组,死亡率低于对照组,差异均有统计学意义(P<0.05);观察组的脱水剂剂量为(826.20±125.66)g,低于对照组的(1276.40±227.00)g,差异有统计学意义(P<0.05);观察组的应用时间为(7.20±3.65)d,短于对照组的(10.80±4.15)d,差异有统计学意义(P<0.05);观察组的并发症总发生率为25.00%,低于对照组的58.33%,差异有统计学意义(P<0.05)。结论在重型颅脑损伤患者术后治疗中采用颅内压持续监护,可减少脱水剂剂量和应用时间,降低并发症发生率,改善患者预后,促进患者早日康复。
Objective To explore the application effect of continuous intracranial pressure monitoring in the treatment of patients with severe craniocerebral injury after operation. Methods A total of 96 patients with severe craniocerebral injury admitted to our hospital from December 2016 to December 2018 were selected as the research objects, they were divided into control group(48 cases) and observation group(48 cases) according to random lottery method. The control group was treated with routine neurosurgery, while the observation group was treated with routine combined with continuous intracranial pressure monitoring. The therapeutic effect, dosage of dehydrant, application time and total incidence of complications were compared between the two groups. Results The good rate of the observation group was higher than that of the control group, and the mortality was lower than that of the control group, the differences were statistically significant(P<0.05). The dosage of dehydrant in the observation group was(826.20±125.66) g, which was lower than(1276.40±227.00) g in the control group, the difference was statistically significant(P<0.05). The application time of the observation group was(7.20±3.65) days, which was shorter than(10.80±4.15) days of the control group, the difference was statistically significant(P<0.05). The total incidence of complications in the observation group was 25.00%,which was lower than 58.33% in the control group, the difference was statistically significant(P <0.05). Conclusion Continuous intracranial pressure monitoring can reduce the dosage and application time of dehydrant, reduce the incidence of complications, improve the prognosis of patients and promote early recovery of patients with severe craniocerebral injury.
Objective To explore the application effect of continuous intracranial pressure monitoring in the treatment of patients with severe craniocerebral injury after operation. Methods A total of 96 patients with severe craniocerebral injury admitted to our hospital from December 2016 to December 2018 were selected as the research objects, they were divided into control group(48 cases) and observation group(48 cases) according to random lottery method. The control group was treated with routine neurosurgery, while the observation group was treated with routine combined with continuous intracranial pressure monitoring. The therapeutic effect, dosage of dehydrant, application time and total incidence of complications were compared between the two groups. Results The good rate of the observation group was higher than that of the control group, and the mortality was lower than that of the control group, the differences were statistically significant(P<0.05). The dosage of dehydrant in the observation group was(826.20±125.66) g, which was lower than(1276.40±227.00) g in the control group, the difference was statistically significant(P<0.05). The application time of the observation group was(7.20±3.65) days, which was shorter than(10.80±4.15) days of the control group, the difference was statistically significant(P<0.05). The total incidence of complications in the observation group was 25.00%,which was lower than 58.33% in the control group, the difference was statistically significant(P <0.05). Conclusion Continuous intracranial pressure monitoring can reduce the dosage and application time of dehydrant, reduce the incidence of complications, improve the prognosis of patients and promote early recovery of patients with severe craniocerebral injury.
引文
[1]郭威,张利花,郝亮.颅内压监护下行腰大池引流在重型颅脑损伤术后的疗效观察[J].重庆医科大学学报,2017,41(10):1266-1269.
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[6]赵鹏洲,柯以铨,吴敬伦,等.重型颅脑损伤患者颅内压与神经元特异性烯醇化酶、D-二聚体及C反应蛋白的相关性研究[J].中华神经医学杂志,2015,14(5):506-510.
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[9]程月飞,王志明,殷尚炯,等.持续颅内压监测下漂浮骨瓣减压术在颅脑损伤中的应用[J].中国临床神经外科杂志,2017,21(6):74-75.
[10]余文运,罗刚,喻坚柏.有创颅内压监测在重型颅脑损伤手术中的应用研究[J].中国现代手术学杂志,2018,22(1):45-48.
[11]袁利群,陈延明,刘士海.持续性颅内压监测应用于急性重型颅脑外伤治疗的意义[J].中国现代医学杂志,2017,27(11):103-107.
[12]舒艳婷,许峰,唐林林,等.持续有创颅内压监测在创伤性脑损伤患儿中的应用价值[J].重庆医科大学学报,2016,40(12):1280-1283.
[13]张超,张鹏,宋建荣,等.颅内压及中心静脉压监测在脑水肿治疗中的应用[J].中华神经外科疾病研究杂志,2017,16(2):138-141.
[14]吴翔,高国一,冯军峰,等.颅脑创伤患者颅内压相关参数与预后关系的研究[J].中华神经外科杂志,2018,34(2):119.
[15]郭建敏,陈根柱,施慧亭.颅内压监护下继发性脑损伤的治疗[J].中华神经外科疾病研究杂志,2016,9(5):451-453.
[2]许勇,李监松,经大平,等.有创颅内压监护改善重型颅脑损伤患者预后的相关因素分析[J].皖南医学院学报,2015,41(3):246-248.
[3]秦德广,黄文勇,杨灵,等.高渗盐水在重型颅脑损伤去骨瓣减压术后颅内高压治疗中的应用研究[J].中华神经医学杂志,2016,15(12):1267-1273.
[4]熊学辉,瞿丹霞.亚低温治疗在急性重型颅脑损伤中的应用[J].新乡医学院学报,2016,33(11):973-975.
[5]李奕冉,孙玉明,俞卫锋,等.深镇静在重型颅脑损伤患者治疗中的临床价值研究[J].中华全科医学,2017,15(9):1463-1465.
[6]赵鹏洲,柯以铨,吴敬伦,等.重型颅脑损伤患者颅内压与神经元特异性烯醇化酶、D-二聚体及C反应蛋白的相关性研究[J].中华神经医学杂志,2015,14(5):506-510.
[7]陈日练.地塞米松对特重型颅脑损伤患者颅内压的影响[J].广西医科大学学报,2014,31(5):845-846.
[8]张禄波,傅继东,遇旭东,等.颅内压监测在重型颅脑损伤病人甘露醇应用中的意义[J].中国临床神经外科杂志,2017,21(5):334-335.
[9]程月飞,王志明,殷尚炯,等.持续颅内压监测下漂浮骨瓣减压术在颅脑损伤中的应用[J].中国临床神经外科杂志,2017,21(6):74-75.
[10]余文运,罗刚,喻坚柏.有创颅内压监测在重型颅脑损伤手术中的应用研究[J].中国现代手术学杂志,2018,22(1):45-48.
[11]袁利群,陈延明,刘士海.持续性颅内压监测应用于急性重型颅脑外伤治疗的意义[J].中国现代医学杂志,2017,27(11):103-107.
[12]舒艳婷,许峰,唐林林,等.持续有创颅内压监测在创伤性脑损伤患儿中的应用价值[J].重庆医科大学学报,2016,40(12):1280-1283.
[13]张超,张鹏,宋建荣,等.颅内压及中心静脉压监测在脑水肿治疗中的应用[J].中华神经外科疾病研究杂志,2017,16(2):138-141.
[14]吴翔,高国一,冯军峰,等.颅脑创伤患者颅内压相关参数与预后关系的研究[J].中华神经外科杂志,2018,34(2):119.
[15]郭建敏,陈根柱,施慧亭.颅内压监护下继发性脑损伤的治疗[J].中华神经外科疾病研究杂志,2016,9(5):451-453.