本文選題：兒童 + 顱腦損傷　； 參考：《重慶醫(yī)學(xué)》2017年20期

【摘要】：目的探討有創(chuàng)顱內(nèi)壓(ICP)監(jiān)測在兒童重型顱腦創(chuàng)傷(sTBI)中的應(yīng)用價值。方法回顧性分析2012年1月至2015年3月該院收治的158例sTBI患兒,根據(jù)是否進(jìn)行有創(chuàng)ICP監(jiān)測將其分為監(jiān)測組(80例)與對照組(78例)。監(jiān)測組術(shù)后24h內(nèi)安裝有創(chuàng)ICP監(jiān)測,并根據(jù)ICP水平采取相應(yīng)處理措施,對照組通過臨床癥狀并根據(jù)經(jīng)驗判斷是否需要復(fù)查頭顱CT與調(diào)整治療方案,傷后3個月按照哥拉斯哥預(yù)后評分(GOS)判斷患兒預(yù)后并進(jìn)行比較分析。同時,比較監(jiān)測組不同ICP水平患兒預(yù)后。結(jié)果監(jiān)測組預(yù)后良好率為61.2%,對照組預(yù)后良好率為41.0%,兩組比較差異有統(tǒng)計學(xué)意義(P0.05)。監(jiān)測組不同ICP水平患兒病死率比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論 sTBI患兒及時安裝有創(chuàng)ICP監(jiān)測能夠動態(tài)觀察ICP變化,及早發(fā)現(xiàn)病情改變,指導(dǎo)臨床治療,改善患兒預(yù)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.
【作者單位】： 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院/兒童發(fā)育疾病研究教育部重點實驗室/兒科學(xué)重慶市重點實驗室/重慶市兒童發(fā)育重大疾病診治與預(yù)防國際科技合作基地重癥醫(yī)學(xué)科;重慶醫(yī)科大學(xué)附屬兒童醫(yī)院/兒童發(fā)育疾病研究教育部重點實驗室/兒科學(xué)重慶市重點實驗室/重慶市兒童發(fā)育重大疾病診治與預(yù)防國際科技合作基地新生兒科;
【基金】：國家自然科學(xué)基金資助項目(81401236)
【分類號】：R726.5

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