中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
10期
995-999
,共5页
张雷%梁平%翟瑄%李禄生%周渝冬%夏佐中%于增鹏%纪文元%周建军
張雷%樑平%翟瑄%李祿生%週渝鼕%夏佐中%于增鵬%紀文元%週建軍
장뢰%량평%적선%리록생%주투동%하좌중%우증붕%기문원%주건군
颅脑损伤%儿童%颅内压%临床特点
顱腦損傷%兒童%顱內壓%臨床特點
로뇌손상%인동%로내압%림상특점
Craniocerebral trauma%Children%Intracranial pressure%Clinical characteristics
目的 分析儿童颅脑创伤后颅内压及脑灌注压的临床特点,为临床治疗提供理论依据. 方法 回顾性分析2012年9月-2013年10月行有创颅内压监测的颅脑创伤儿童68例,按年龄分为0～2岁组(13例)、2～7岁组(33例)和7～16岁组(22例),分析不同年龄组的颅内压、脑灌注压随时间、年龄的变化特点,及其与预后的关系和影响因素. 结果 术后24 h左右颅内压达高峰,脑灌注压达低谷,前者在3～5d后逐渐下降并稳定,后者在2～3d后轻微回升并稳定.颅内压水平:0～2岁组(16.1 ±1.6)mmHg,2～7岁组(16.9±1.6) mmHg,7～16岁组(19.9±1.5) mmHg,两两比较差异有统计学意义(P＜0.05).脑灌压水平:0～2岁组(52.5±2.3) mmHg,2～7岁组(54.3±1.7)mmHg,7～16岁组(58.0±1.9) mmHg,两两比较差异有统计学意义(P＜0.01).颅内压≥30 mmHg、脑灌注压＜40 mmHg与患儿预后不良有关. 结论 制订年龄特异性的颅内压和脑灌注压治疗阈值,对颅脑创伤儿童的治疗及预后判断有重要指导意义.
目的 分析兒童顱腦創傷後顱內壓及腦灌註壓的臨床特點,為臨床治療提供理論依據. 方法 迴顧性分析2012年9月-2013年10月行有創顱內壓鑑測的顱腦創傷兒童68例,按年齡分為0～2歲組(13例)、2～7歲組(33例)和7～16歲組(22例),分析不同年齡組的顱內壓、腦灌註壓隨時間、年齡的變化特點,及其與預後的關繫和影響因素. 結果 術後24 h左右顱內壓達高峰,腦灌註壓達低穀,前者在3～5d後逐漸下降併穩定,後者在2～3d後輕微迴升併穩定.顱內壓水平:0～2歲組(16.1 ±1.6)mmHg,2～7歲組(16.9±1.6) mmHg,7～16歲組(19.9±1.5) mmHg,兩兩比較差異有統計學意義(P＜0.05).腦灌壓水平:0～2歲組(52.5±2.3) mmHg,2～7歲組(54.3±1.7)mmHg,7～16歲組(58.0±1.9) mmHg,兩兩比較差異有統計學意義(P＜0.01).顱內壓≥30 mmHg、腦灌註壓＜40 mmHg與患兒預後不良有關. 結論 製訂年齡特異性的顱內壓和腦灌註壓治療閾值,對顱腦創傷兒童的治療及預後判斷有重要指導意義.
목적 분석인동로뇌창상후로내압급뇌관주압적림상특점,위림상치료제공이론의거. 방법 회고성분석2012년9월-2013년10월행유창로내압감측적로뇌창상인동68례,안년령분위0～2세조(13례)、2～7세조(33례)화7～16세조(22례),분석불동년령조적로내압、뇌관주압수시간、년령적변화특점,급기여예후적관계화영향인소. 결과 술후24 h좌우로내압체고봉,뇌관주압체저곡,전자재3～5d후축점하강병은정,후자재2～3d후경미회승병은정.로내압수평:0～2세조(16.1 ±1.6)mmHg,2～7세조(16.9±1.6) mmHg,7～16세조(19.9±1.5) mmHg,량량비교차이유통계학의의(P＜0.05).뇌관압수평:0～2세조(52.5±2.3) mmHg,2～7세조(54.3±1.7)mmHg,7～16세조(58.0±1.9) mmHg,량량비교차이유통계학의의(P＜0.01).로내압≥30 mmHg、뇌관주압＜40 mmHg여환인예후불량유관. 결론 제정년령특이성적로내압화뇌관주압치료역치,대로뇌창상인동적치료급예후판단유중요지도의의.
Objective To analyze the clinical characteristics of intracranial pressure and cerebral perfusion pressure after craniocerebral trauma in children so as to guide the clinical therapy.Methods A retrospective review was conducted on 68 children with craniocerebral trauma undergone continuous invasive intracranial pressure monitoring from September 2012 to October 2013.The children were assigned to 3 age groups:0-2 years (13 cases),2-7 years (33 cases),and 7-16 years (22 cases).Characteristics of intracranial pressure and cerebral perfusion were detected over time and age and measured for their correlation with the prognosis and related influential factors.Results Intracranial pressure ascended to the peak point at postoperative 24 hours and decreased to a stable level at postoperative 3-5 days.Cerebral perfusion pressure descended to the valley at postoperative 24 hours,followed by a slight return and stabilized at postoperative 2-3 days.Intracranial pressure was (16.1 ± 1.6) mmHg in children aged 0-2 years,(16.9 ± 1.6) mmHg in children aged 2-7 years,and (19.9 ± 1.5) mmHg in children aged 7-16 years,with statistical difference in pair comparison (P ＜ 0.05) ; cerebral perfusion pressure was (52.5 ± 2.3) mmHg in children aged 0-2 years,(54.3 ± 1.7) mmHg in children aged 2-7 years,and (58.0 ± 1.9) mmHg in children aged 7-16 years,with statistical significance in pair comparison (P ＜ 0.01).Intracranial pressure ＞ 30 mmHg and cerebral perfusion pressure ＜ 40 mmHg were associated with poor outcome.Conclusion Age-specific thresholds developed for intracranial pressure and cerebral perfusion pressure is instructive to the clinical therapy and prognostic prediction.
