联合头颅CT和甘露醇后腰穿测压的小儿降颅压方案的可行性探讨

Evaluation on the control of intracranial hypertension by CT Scan and lumbar CSF pressure

目的探讨临床上简便易行而有效的控制颅高压方案,即本文提出的联合应用头颅CT和甘露醇后腰穿测压的降颅压方案的可行性分析。方法将42例Glasgow<8分颅高压患儿分为经验性降颅压组(经验组)26例和联合头颅CT和甘露醇后腰穿测压组(新方案组)16例,比较两组的Glasgow评分、甘露醇用法、预后等。结果两组患儿的年龄、Glasgow评分、尿素氮、肌酐、平均动脉压、血钠、PCO2无明显差异,而两组甘露醇用法有显著性差异(χ2=25.321,P<0.001),结果两组死亡、好转、恶化、发生脑疝病例数明显不同(χ2=24.44,P<0.001)。结论联合应用头颅CT和甘露醇后腰穿测压的降颅压方案简便易行而有效。

Objective To study effective and easy protocol that controls intracranial hypertension by CT scan and lumbar CSF pressure. Methods 42 patients of GCS scores of 3 to 8 were divided into two groups, experienced group（26 patients）and new protocol group（ 16 patients）. GCS scores, uses of mannitol, and prognosis, et al were compared. Results The age, Glasgow scores, BUN, Cr, MAP, sodium, PCO2 of two groups were similar. Treated methods of mannitol of two groups were different （X^2=25. 321, P〈0. 001）. The mortality, improvement, deterioration, herniation of two groups were also different significantly （X^2=24.44, P〈0.001）. Conclusion The protocol monitoring intracranial hypertension by CT scan and lumbar CSF pressure post mannitol are effective and easy.