中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
12期
18-20
,共3页
单侧脑挫裂伤%闪光视觉诱发电位无创颅内压监护%血肿变化%预警
單側腦挫裂傷%閃光視覺誘髮電位無創顱內壓鑑護%血腫變化%預警
단측뇌좌렬상%섬광시각유발전위무창로내압감호%혈종변화%예경
Unilateral cerebral laceration%Flash visual evoked potential noninvasive intracranial pressure monitoring%Unilateral contusion%Early-warning
目的 探讨闪光视觉诱发电位颅内压监护技术(FVEP-NICP)在单侧脑挫裂伤患者继发颅内血肿扩大的预警作用及对预后的判断意义.方法 前瞻性应用FVEP-NICP监测技术对2012年至2013年解放军153医院收治的96例单侧脑挫伤患者进行监护,结合头颅CT分为血肿增加组与血肿稳定组,对两组的NICP及挫伤侧与健侧NICP的差值(D值)及预后进行对比分析,预后根据伤后6个月的GOS评分分为恢复良好患者(GOS 4～5分)与恢复不良患者(GOS 1 ～3分).结果 血肿增加组38例(39.6％)的NICP值及D值较入院时显著增高(P值分别为0.015和0.002);血肿稳定组58例(60.4％)的NICP值及D值较入院时无明显增高(P值分别为0.583和0.621);对D值≥60 mm H2O(1 mm H2O =0.0098 kPa)的人数分析,入院首测两组之间差异未见统计学意义(P＞0.05),复测时血肿增大组人数较血肿稳定组显著增多(P＜0.01).血肿增加组恢复良好患者15例(39.5％),恢复不良者23例(60.5％);血肿稳定组恢复良好者49例(84.5％),恢复不良者9例(15.5％),血肿增大组预后良好率显著低于血肿不变组(P=0.013).结论 闪光视觉诱发电位无创颅内压监测技术结合头颅CT对单侧脑挫裂伤患者继发血肿增大具有良好的预警作用.
目的 探討閃光視覺誘髮電位顱內壓鑑護技術(FVEP-NICP)在單側腦挫裂傷患者繼髮顱內血腫擴大的預警作用及對預後的判斷意義.方法 前瞻性應用FVEP-NICP鑑測技術對2012年至2013年解放軍153醫院收治的96例單側腦挫傷患者進行鑑護,結閤頭顱CT分為血腫增加組與血腫穩定組,對兩組的NICP及挫傷側與健側NICP的差值(D值)及預後進行對比分析,預後根據傷後6箇月的GOS評分分為恢複良好患者(GOS 4～5分)與恢複不良患者(GOS 1 ～3分).結果 血腫增加組38例(39.6％)的NICP值及D值較入院時顯著增高(P值分彆為0.015和0.002);血腫穩定組58例(60.4％)的NICP值及D值較入院時無明顯增高(P值分彆為0.583和0.621);對D值≥60 mm H2O(1 mm H2O =0.0098 kPa)的人數分析,入院首測兩組之間差異未見統計學意義(P＞0.05),複測時血腫增大組人數較血腫穩定組顯著增多(P＜0.01).血腫增加組恢複良好患者15例(39.5％),恢複不良者23例(60.5％);血腫穩定組恢複良好者49例(84.5％),恢複不良者9例(15.5％),血腫增大組預後良好率顯著低于血腫不變組(P=0.013).結論 閃光視覺誘髮電位無創顱內壓鑑測技術結閤頭顱CT對單側腦挫裂傷患者繼髮血腫增大具有良好的預警作用.
목적 탐토섬광시각유발전위로내압감호기술(FVEP-NICP)재단측뇌좌렬상환자계발로내혈종확대적예경작용급대예후적판단의의.방법 전첨성응용FVEP-NICP감측기술대2012년지2013년해방군153의원수치적96례단측뇌좌상환자진행감호,결합두로CT분위혈종증가조여혈종은정조,대량조적NICP급좌상측여건측NICP적차치(D치)급예후진행대비분석,예후근거상후6개월적GOS평분분위회복량호환자(GOS 4～5분)여회복불량환자(GOS 1 ～3분).결과 혈종증가조38례(39.6％)적NICP치급D치교입원시현저증고(P치분별위0.015화0.002);혈종은정조58례(60.4％)적NICP치급D치교입원시무명현증고(P치분별위0.583화0.621);대D치≥60 mm H2O(1 mm H2O =0.0098 kPa)적인수분석,입원수측량조지간차이미견통계학의의(P＞0.05),복측시혈종증대조인수교혈종은정조현저증다(P＜0.01).혈종증가조회복량호환자15례(39.5％),회복불량자23례(60.5％);혈종은정조회복량호자49례(84.5％),회복불량자9례(15.5％),혈종증대조예후량호솔현저저우혈종불변조(P=0.013).결론 섬광시각유발전위무창로내압감측기술결합두로CT대단측뇌좌렬상환자계발혈종증대구유량호적예경작용.
Objective To investigate the clinical significance of flash visual evoked potentialnoninvasive intracranial pressure monitoring and prognostic of early-warning hematoma enlargement in patients with secondary intracranial hematoma of unilateral cerebral laceration.Methods Ninety-six cases with unilateral cerebral laceration were continuously monitored FVEP-NICP in the 153rd Hospital of PLA from 2012 to 2013,they were divided into the hematoma expanded group and the hematoma stable group based on brain CT.An analysis and comparision between the two groups were performed focusing on characteristics,such as the differences of NICP between the hematoma side and the healthy side(D value),and the Glasgow prognosis scores(GOS) were analyzed and compared between the two groups.Patients prognosis were divided into recovery well (GOS 4-5) and lack of recovery (GOS 1-3) according to the GOS of 6 months after injury.Results NICP and D value in the hematoma expanded group significantly increased from first detection (P =0.015 and 0.002),while there were no significant increasing of NICP and D value in hematoma stable group (P =0.538 and 0.621).In hematoma group,15 cases recovered well,23 cases were lack of recovery.In hematoma stable group,49 cases recovered well,9 cases were lack of recovery.The rate of favorable prognosis of hematoma expanded group was significantly lower than that of the hematoma stable group (P =0.013).Conclusions FVEP-NICP combined with head CT has good warning effect on patients with secondary intracranial hematoma of unilateral cerebral laceration.
