无创颅内压监护在外科治疗大面积脑梗塞中的应用

Clinical Application of Noninvasive Intracranial Pressure Monitoring in Decompress Craniectomy of Extensive Brain Infarction

目的:探讨无创颅内压监护在治疗大面积脑梗塞中的指导作用及判断预后的价值。方法:22例大面积脑梗塞患者,当3.53 kPa≤颅内压(ICP)≤5.53 kPa,采用去大骨瓣外减压术;当ICP>5.53 kPa,均采用去大骨瓣外减压术+内减压术。结果:术后3月按格拉斯哥结果评分(GOS),3.53 kPa≤ICP≤5.53 kPa组(14例),良好及中残13例(59%);5.53 kPa<ICP<8 kPa组(6例),重残6例(28%);ICP≥8 kPa组2例(13%),该组均死亡。结论:无创颅内压监护在治疗大面积脑梗塞决定术式和判断预后中有指导作用。

Objective： To investigate the application of noninvasive intracranial pressure （NICP） monitoring in decompress craniectomy to treat extensive brain infarction. Methods： As their ICP was between 3.53 to 5.53 kPa, the patients with extensive brain infarction were treated with decompression by standard craniectomy; when ICP〉5.53 kPa, they were treated with decompression by standard craniectomy plus interdecompression. Results： After three months, 59% patients with 3.53 kPa≤ICP≤5.53 kPa gained satisfactory outcomes, 28% patients with 5.53 kPa〈ICP 〈8 kPa had poor outcomes, and all the two cases with ICP≥8 kPa were dead. Conclusion： NICP monitoring is useful for the treatment and prognostic of extensive infarction patients.