无创颅内压与中心静脉压监测在重型颅脑损伤中的应用

杨磊，黄斌，钟伟，唐维凯

（广西桂林市人民医院神经外科，广西 桂林，541002）

浏览次数：118次 下载次数：350次

摘要：

目的 探析重型颅脑损伤治疗中运用无创颅内压与中心静脉压监测的临床效果。方法 选择2014年1月至2015年10月我院收治的68例重型颅脑损伤患者为研究对象，根据电脑随机法将其分为两组，各34例。非监测组采取神经外科常规监护及治疗，监测组使用MICP-1A型颅内压无创检测分析仪对患者颅内压进行监测，并联合深静脉穿刺置管行中心静脉压监测，比较两组患者的治疗效果。结果治疗后，监测组患者的良好率高于非检测组，死亡率低于非检测组，差异有统计学意义（P<0.05）；相比非监测组患者，监测组患者的住院时间更短，且液体量更少，差异有统计学意义（P<0.05）；监测组患者的并发症发生率低于非检测组（P<0.05）；同时，两组患者的DBP、SBP、HR、MAP及颅内压等指标比较，差异有统计学意义（P<0.05）。结论 临床上给予重型颅脑损伤患者中心静脉压与无创颅内压联合监测，能更早地发现颅内压变化情况，科学可靠地指导颅 脑损伤的液体治疗，降低并发症发生率，缩短住院时间，明显提高重型颅脑损伤患者的救治效果。

关键词：重型颅脑损伤；中心静脉压；无创颅内压

中图分类号：R651.1文献标志码：A文章编号：2096-1413(2017)03-0001-03

Application of noninvasive intracranial pressure and central venous pressure

 monitoring in severe craniocerebral injury
YANG Lei, HUANG Bin, ZHONG Wei, TANG Wei-kai
(Department of Neurosurgery, Guilin People's Hospital, Guilin 541002, China)

ABSTRACT: Objective To analyze the effect of noninvasive intracranial pressure and central venous pressure monitoring in treatment of severe craniocerebral injury. Methods Sixty -eight cases of patients with severe craniocerebral injury admitted in our hospital from January 2014 to October 2015 were selected as research objects, and divided into two groups according to the computer random method, with 34 cases in each group. The non-monitoring group accepted neurosurgical routine monitoring and treatment, while the monitoring group received MICP-1A noninvasive intracranial pressure detection analyzer to monitor intracranial pressure, and deep vein puncture catheter to monitor central venous pressure. The therapeutic effect were compared in the two groups. Results After treatment, the effective rate and death rate of the monitoring group was significantly superior than the non-monitoring group (P<0.05); compared to the non-monitoring group,the monitoring group had shorter hospitalization time, less liquid, the differences between the two groups were significant (P<0.05); the incidence of complications in the non-monitoring group were significantly lower than that in the monitoring group (P<0.05); meanwhile, the differences of DBP, SBP, HR, MAP and intracranial pressure levels between the two groups were statistically significant (P<0.05). Conclusion In clinic, central venous pressure with noninvasive intracranial pressure monitoring used in severe craniocerebral injury patients can earlier detect intracranial pressure change, guide liquid treatment of craniocerebral injury scientifically and reliably, reduce complications, shorten hospitalization time, and significantly improve the treatment efficacy of patients with severe craniocerebral injury.
KEYWORDS: severe craniocerebral injury; central venous pressure; noninvasive intracranial pressure

参考文献：
[1] 周玲,汤蓓,相鹏,等.脉搏指数连续心输出量技术在重型颅脑损伤液体管理中的应用分析[J].中华全科医学,2015,13(2):216-218.
[2] 杨磊,黄斌,钟伟.无创颅内压与中心静脉压联合监测在重型颅脑损伤治疗中的临床应用[J].中国医药科学,2015,5(3):41-44.
[3] 戴巍,程亮,夏玉兰,等.颅内压及颈静脉氧饱和度联合监测在重型颅脑损伤中的应用[J].中国医药导报,2011,8(30):188-189.
[4] 姜德华,王晓猛,王博,等.快速输入4益生理盐水诱导亚低温治疗重型颅脑损伤的初步研究[J].中华临床医师杂志:电子版,2013,7(4):1561-1564.
[5] 陈甘海,李金庭,林燕金.PICCO技术在重型颅脑损伤液体管理中的应用探讨[J].白求恩军医学院学报,2013,11(4):317-319.
[6] 阳建国,汪一棋,赵朝辉.脉搏指数连续心输出量技术在重型颅脑损伤患者中的应用分析[J].中华危重症医学杂志:电子版,2016,9(1):44-46.
[7] 徐兰娟,李保林,杨彩浮.早期呼吸机模拟高压氧治疗重型颅脑损伤的疗效分析[J].中华神经创伤外科电子杂志,2016,2(4):210-214.
[8] 叶高峰,温兴杰,汤文杰.PICCO监测和CVP 压力监测指导下的重型颅脑损伤患者液体复苏疗效的比较研究[J].浙江创伤外科,2014,19(5):704-707.
[9] 陈甘海,李金庭,林燕金.PICCO技术与中心静脉压监测在重型颅脑损伤液体管理中的应用分析[J].中西医结合心脑血管病杂志,2014,12(11):1346-1348.