无创颅内压监测在重型颅脑损伤中的临床应用分析

Clinical application of noninvasive intracranial pressure monitoring in severe traumatic brain injury

目的观察无创颅内压监测在重型颅脑损伤中的临床应用效果。方法选取该院2011年1月至2013年1月收治的重型颅脑损伤患者60例作为临床研究对象,并将其分为观察组和传统对照组,各30例。另选取30例健康者作为健康对照组。传统对照组行脑室外引流术和传统颅内压检测,观察组与健康对照组则采用无创颅内压检测,记录三组患者的颅内压值和患者的病死率,以及重型颅脑损伤患者的并发症发生情况,同时分析三组患者的血压、脉搏和呼吸。结果观察组与传统对照组颅内压检测值比较,差异无统计学意义(P>0.05)。观察组与传统对照组死亡率分别为20.0%(6/30)、23.3%(7/30),两组比较,差异无统计学意义(P>0.05)。观察组、传统对照组较健康对照组血压明显升高,而观察组和传统对照组比较,差异无统计学意义(P>0.05)。观察组所有患者无一例出现严重并发症,传统对照组有1例患者出现颅内感染、1例患者出现脑脊液漏,并发症发生率为6.7%,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论无创颅内压检测与有创颅内压检测差异不大,且操作简单、安全,可替代传统有创颅内压检测,值得临床推广应用。

Objective To observe the clinical efficacy of noninvasive intracranial pressure monitoring in severe traumat- ic brain injury. Methods 60 patients with severe traumatic brain injury ,who were enrolled in the hospital from January 2001 to January 2013 ,were selected as clinical objects and divided into observation group and traditional control group with 30 cases in each group. 30 cases of healthy respondents were taken as healthy control group. The traditional control group was with extra ven- tricular drainage and traditional intracranial pressure monitoring,while the observation group and healthy control group were both adopted noninvasive intracranial pressure monitoring. To record the intracranial pressure value and mortality rate of the patients in the three groups ,and the complications of patients with severe traumatic brain injury simultaneously, and to analyze the blood pressure, pulse and respiration in the three groups. Results The difference between observation group and traditional control group on intracranial pressure value had no statistical significance （P〉O.05）. The mortality rates were 20.0% （6/30） in observation group and 23.3% （7/30） in traditional control healthy group with statistically significant difference （/：＇〉0.05）. The blood pressure of observation group and traditional control group was obviously higher than that in healthy control group ,and the difference between the two groups had statistical significance （/9〉0.05）. No serious complication occurred in observation group, and 1 case of intracra- nial infection and 1 case of leakage of cerebrospinal fluid appeared in the traditional control group with the complications occur rence rate of 6.7%, and the difference between the two groups on occurrence rate had no statistical significance （P〉0.05）. Conelu- slon Noninvasive intraeranial pressure monitoring,which is safe and easy to operate, has little difference with accurate invasive intraeranial pressure monitoring, and it can replace the traditional intraeranial pressure monitoring, so it is worthy of promotion in clinic.