CAJ | 학술논문

目的探讨重型颅脑损伤(sTBI)患者术中持续脑灌注压(CPP)监测的意义.方法解放军第一○一医院2009年6月至2011年12月收治的63例sTBI患者根据预后情况分为较好(GOS 4～5分)及较差(GOS 1～3分)两组,对两组患者术中CPP、平均动脉压(MAP)及颅内压(ICP)的变化进行相关性分析.结果两组间ICP、CPP总体差异有统计学意义(P＜0.05),而两组间MAP总体差异无统计学意义(P＞0.05)；各组内ICP、MAP及CPP在不同时间点变化的差异有统计学意义(P＜0.05)；两组间ICP、MAP及CPP在不同时间点变化的差异有统计学意义(P＜0.05).结论术中持续CPP监测有助于术者及时判断和处理术中出现的病情变化,对改善sTBI患者的预后可能有着积极的临床意义.
목적 탐토중형로뇌손상(sTBI)환자술중지속뇌관주압(CPP)감측적의의.방법 해방군제일○일의원2009년6월지2011년12월수치적63례sTBI환자근거예후정황분위교호(GOS 4～5분)급교차(GOS 1～3분)량조,대량조환자술중CPP、평균동맥압(MAP)급로내압(ICP)적변화진행상관성분석.결과 량조간ICP、CPP총체차이유통계학의의(P＜0.05),이량조간MAP총체차이무통계학의의(P＞0.05)；각조내ICP、MAP급CPP재불동시간점변화적차이유통계학의의(P＜0.05)；량조간ICP、MAP급CPP재불동시간점변화적차이유통계학의의(P＜0.05).결론 술중지속CPP감측유조우술자급시판단화처리술중출현적병정변화,대개선sTBI환자적예후가능유착적겁적림상의의.
Objective To explore the significance of intraoperative continuous monitoring of cerebral perfusion pressure (CPP) in the treatment of patients with severe traumatic brain injury (sTBI).Methods We made an observational retrospective study involving a group with 63 patients diagnosed as sTBI from June 2009 to December 2011.According to the prognosis,patients were divided into two group:the good group (GOS 4 ～ 5) and the poor group (GOS 1 ～ 3).We made multiple correlations to analyze the variance of intraoperative CPP、MAP,and ICP between the two groups.Statistical signification was P ＜ 0.05.Results There were significant differences between the two groups in the variance of ICP and CPP (P ＜ 0.05),and MAP fluctuations between the two groups did not have statistical significance (P ＞0.05).The changes of intraoperative ICP、MAP,and CPP at different time points showed significant differences and statistical signification (P ＜ 0.05),whether in groups or between groups.Conclusion Intraoperative continuous monitoring of CPP can help surgeons to judge and deal with the intraoperative condition changes timely and may even have a positive clinical significance to improve the prognosis of sTBI patients.