摘要
目的探究重型颅脑损伤患者去骨瓣减压术后颅内压持续监测对预后产生的影响。方法选取该院2016年2月—2019年6月收治的80例重型颅脑损伤患者为研究对象,均行去骨瓣减压术,对照组患者行一般颅内压监测,观察组行颅内压持续监测,对比两组预后、甘露醇应用剂量与时间、并发症发生情况。结果观察组患者病死率、长期昏迷/重度残疾率分别为5.00%、12.50%,均低于对照组,恢复良好/中度残疾率为82.50%,高于对照组,差异有统计学意义(χ2=8.658、4.588、16.875,P<0.05);观察组甘露醇应用剂量为(822.18±8.58)g,少于对照组,应用时间为(7.02±1.08)d,短于对照组,差异有统计学意义(t=172.245、8.212,P<0.05);观察组电解质紊乱、急性肾功能损伤发生率分别为12.50%、2.50%,均低于对照组,差异有统计学意义(χ2=11.667、11.114,P<0.05)。结论重型颅脑损伤患者去骨瓣减压术后行颅内压持续监测利于改善预后,降低并发症发生率,减少甘露醇应用量。
Objective To explore the effect of continuous monitoring of intracranial pressure on the prognosis of patients with severe head injury after decompressive craniectomy.Methods Eighty patients with severe head injury admitted to the hospital from February 2016 to June 2019 were selected as the research objects.All patients underwent decompressive craniectomy.Patients in the control group underwent general intracranial pressure monitoring,and the observation group underwent intracranial pressure and the pressure was continuously monitored,and the prognosis,mannitol application dose and time,and complications were compared between the two groups.Results The mortality rate and the long-term coma/severe disability rate of the observation group were 5.00%and 12.50%,respectively,which were lower than those of the control group,and the good recovery/moderate disability rate was 82.50%,which was higher than the control group,the difference was statistically significant(χ2=8.658,4.588,16.875,P<0.05);the application dose of mannitol in the observation group was(822.18±8.58)g,which was less than the control group,and the application time was(7.02±1.08)d,which was shorter than the control group,the difference was statistically significant(t=172.245,8.212,P<0.05);the rates of electrolyte imbalance and acute renal function injury in the observation group were 12.50%and 2.50%,respectively,which were lower than those in the control group,the difference was statistically significant(χ2=11.667,11.114,P<0.05).Conclusion Continuous monitoring of intracranial pressure after decompressive craniectomy in patients with severe head injury can improve the prognosis,reduce the incidence of complications,and reduce the amount of mannitol used.
作者
周立田
杨平来
余前
张建波
ZHOU Li-tian;YANG Ping-lai;YU Qian;ZHANG Jian-bo(Department of Neurosurgery,Lishui Hospital,Zhongda Hospital,Southeast University,Lishui District People's Hospital,Nanjing,Jiangsu Province,211200 China)
出处
《系统医学》
2020年第19期10-12,共3页
Systems Medicine
关键词
重型颅脑损伤
去骨瓣减压术
颅内压
持续监测
预后
Severe head injury
Decompressive cranie ctomy
Intracranial pressure
Continuous monitoring
Prognosis
作者简介
周立田(1979-),男,硕士,副主任医师,研究方向:颅脑外伤;通信作者:杨平来(1971-),男,本科,主任医师,研究方向:颅脑外伤,E-mail:lsyyypl@163.com。
