广州医药 ›› 2023, Vol. 54 ›› Issue (2): 79-82.DOI: 10.3969/j.issn.1000-8535.2023.02.016

• 论著 • 上一篇    下一篇

ICP监测联合浮动骨瓣减压术治疗颅脑损伤的临床疗效

孙向, 刘永生, 李想, 郭士琨   

  1. 商丘市第一人民医院神经外科(商丘 476000)
  • 收稿日期:2022-03-22 出版日期:2023-02-20 发布日期:2023-02-27

Clinical efficacy of ICP monitoring combined with floating bone flap decompression for craniocerebral injury

SUN Xiang, LIU Yongsheng, LI Xiang, GUO Shikun   

  1. Neurosurgery Department, First People's Hospital of Shangqiu City, Shangqiu 476000, China
  • Received:2022-03-22 Online:2023-02-20 Published:2023-02-27

摘要: 目的 研究颅内压(ICP)监测联合浮动骨瓣减压术在治疗颅脑损伤中对颅内压及脑血流指标的影响。方法 选取我院2019年3月—2021年3月收治的拟行骨瓣减压术的颅脑损伤患者106例作为研究对象,按照手术方法不同分为对照组(n=53)、观察组(n=53)。对照组采用传统去骨瓣减压术(DC)治疗,观察组采用ICP监测联合浮动骨瓣减压术治疗。对比2组ICP、脑血流指标[平均流速(Vm)、收缩期血流速度(Vs)、血管搏动指数(PI)]及并发症发生情况。结果 术后1、3、7 d观察组ICP、PI低于对照组,Vm、Vs高于对照组(P<0.05);术后观察组并发症总发生率9.43%低于对照组37.74%(P<0.05)。结论 采用ICP监测联合浮动骨瓣减压术治疗颅脑损伤能降低患者ICP,改善脑血流状态,降低术后并发症,避免二次手术,减轻患者经济负担。

关键词: 颅内压监测, 浮动骨瓣减压术, 颅脑损伤, 脑血流指标

Abstract: Objective To study the effect of intracranial pressure (ICP) monitoring combined with floating bone flap decompression on intracranial pressure and cerebral blood flow index in the treatment of craniocerebral injury. Methods A total of 106 patients admitted to our hospital from March 2019 to March 2021 were selected as study subjects and divided into control group (n=53) and observation group (n=53).The control group was treated with traditional decompressed craniectomy (DC), and the observation group was treated with ICP monitoring combined with floating bone flap decompression.The ICP, cerebral blood flow index [mean flow velocity (Vm), systolic flow velocity (Vs), vascular pulsatility index (PI)] and complications were compared between the two groups. Results ICP and PI were lower in observation groups on 1,3 and 7 d, Vm and Vs were higher (P <0.05); the incidences of complications in observation group (9.43%), such as electrolyte disorder, pulmonary infection, abnormal renal function and incisional hernia, were lower in the control group (37.74%, P<0.05). Conclusions ICP monitoring combined with floating bone flap decompression could reduce ICP, improve cerebral blood flow, reduce postoperative complications, avoid secondary surgery and reduce economic burden.

Key words: intracranial pressure monitoring, floating bone flap decompression, craniocerebral injury, cerebral blood flow index