有创颅内压监测在儿童重型颅脑创伤中应用价值的研究

发布时间：2018-05-22 10:25

本文选题：儿童 + 颅脑损伤　；参考：《重庆医学》2017年20期

【摘要】：目的探讨有创颅内压(ICP)监测在儿童重型颅脑创伤(sTBI)中的应用价值。方法回顾性分析2012年1月至2015年3月该院收治的158例sTBI患儿,根据是否进行有创ICP监测将其分为监测组(80例)与对照组(78例)。监测组术后24h内安装有创ICP监测,并根据ICP水平采取相应处理措施,对照组通过临床症状并根据经验判断是否需要复查头颅CT与调整治疗方案,伤后3个月按照哥拉斯哥预后评分(GOS)判断患儿预后并进行比较分析。同时,比较监测组不同ICP水平患儿预后。结果监测组预后良好率为61.2%,对照组预后良好率为41.0%,两组比较差异有统计学意义(P0.05)。监测组不同ICP水平患儿病死率比较,差异有统计学意义(P0.05)。结论 sTBI患儿及时安装有创ICP监测能够动态观察ICP变化,及早发现病情改变,指导临床治疗,改善患儿预后。
[Abstract]:Objective to evaluate the value of ICP monitoring in severe traumatic brain injury (TBI) in children. Methods from January 2012 to March 2015, 158 cases of sTBI were retrospectively analyzed. According to the invasive ICP monitoring, they were divided into two groups: the monitoring group (n = 80) and the control group (n = 78). Invasive ICP monitoring was installed in the monitoring group within 24 hours after operation, and the corresponding treatment measures were taken according to the level of ICP. The control group was judged by clinical symptoms and experience as to whether it was necessary to review head CT and adjust the treatment plan. Three months after injury, the prognosis of the children was evaluated according to Gorasgow prognostic score (GOS) and compared. At the same time, the prognosis of children with different ICP levels was compared. Results the good prognosis rate in the monitoring group was 61.2 and the good prognosis rate in the control group was 41.0. The difference between the two groups was statistically significant (P 0.05). The mortality of children with different ICP levels in the monitoring group was significantly higher than that in the control group (P 0.05). Conclusion timely installation of invasive ICP monitoring in children with sTBI can dynamically observe the changes of ICP, detect the changes of disease as early as possible, guide clinical treatment and improve the prognosis of children.
【作者单位】：重庆医科大学附属儿童医院/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室/重庆市儿童发育重大疾病诊治与预防国际科技合作基地重症医学科;重庆医科大学附属儿童医院/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室/重庆市儿童发育重大疾病诊治与预防国际科技合作基地新生儿科;
【基金】：国家自然科学基金资助项目(81401236)
【分类号】：R726.5

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