摘要
目的初步探讨颅脑创伤开颅手术后脑池开放引流监测颅内压(ICPc)与脑室外引流监测颅内压(ICPv)的相关性和一致性。方法以2019年5月至2020年7月行开颅血肿清除术的4例颅脑创伤患者作为观察对象,术后第1~7天同时行脑池开放引流和脑室外引流颅内压监测,Pearson相关分析和Bland-Altman一致性检验探讨二者的相关性和一致性。结果4例患者术后分别获得有效颅内压测值106、87、56和99次,脑室外引流颅内压测值分别为(14.72±5.98)、(11.10±4.49)、(27.29±6.06)和(12.63±5.36)mm Hg,脑池开放引流测值为(14.32±5.44)、(11.20±4.36)、(25.46±5.00)和(12.46±5.21)mm Hg。4例患者术后脑池开放引流与脑室外引流颅内压均呈正相关(r=0.977,P=0.000;r=0.961,P=0.000;r=0.892,P=0.000;r=0.970,P=0.000);二者平均差值为(0.21±1.36)mm Hg,95%LoA为-2.440~2.870(P=0.003)。结论脑室外引流与脑池开放引流颅内压监测具有良好的相关性和一致性,脑池开放引流颅内压监测可用于颅脑创伤患者的临床诊断与治疗,并有望成为脑室外引流颅内压监测的备选方案。
Objective To explore the feasibility and accuracy of cisternal intracranial pressure(ICPc) monitoring after craniotomy in traumatic brain injury(TBI).Methods Four TBI patients underwent evacuation of hematoma were enrolled from May 2019 to July 2020.Ventriculostomy and cisternotomy were performed besides evacuation,and intracranial pressure(ICP) were monitored via the methods of extraventricular drainage(EVD) and cisternal drainage(CD) simultaneously for 7 d after craniotomy.The correlation and consistency between ICPc and ventricular ICP(ICPv) were observed.Results The mean values of ICPv were(14.72±5.98),(11.10±4.49),(27.29±6.06) and(12.63±5.36) mm Hg,respectively.The mean values of IC.Pc were(14.32±5.44),(11.20±4.36),(25.46±5.00) and(12.46±5.21) mm Hg,respectively.The correlation coefficients were 0.977(P=0.000),0.961(P=0.000),0.892(P=0.000) and0.970(P=0.000),respectively.Using Bland-Altman consistency evaluation,the mean ICP difference between IC.Pv and ICPc was(0.21±1.36) mm Hg,95%LoA was-2.440-2.870(P=0.003).Conclusions ICPc and ICPv have good linear correlation and consistency.ICP monitoring through the method of cisternotomy and drainage can be applied to the clinical management of patients with TBI,and is likely to become an alternative method for ICPv.
作者
刘俊
张述升
王伟
郭芳
王均伟
王博
李中振
张国斌
LIU Jun;ZHANG Shu⁃sheng;WANG Wei;GUO Fang;WANG Jun⁃wei;WANG Bo;LI Zhong⁃zhen;ZHANG Guo⁃bin(Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300350,China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2020年第7期597-601,共5页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
天津市临床重点学科(专科)建设项目
关键词
脑损伤
创伤性
颅内压
脑脊髓液
引流术
Brain injuries,traumatic
Intracranial pressure
Cerebrospinal fluid
DrainageThis study was supported by Tianjin Key Clinical Discipline Construction Project
