Study on the application of intraventricular intracranial pressure monitoring in perioperative period of patients with severe craniocerebral injury

doi:10.3877/cma.j.issn.2095-123X.2022.03.005

Abstract

Abstract:

Objective

To explore the effect of intraventricular intracranial pressure monitoring in patients with severe craniocerebral injury during perioperative period.

Methods

One hundred and twelve patients with severe craniocerebral injury treated in the Neurosurgery Department of Deyang People's Hospital from January 2019 to August 2020 were divided into observation group and conventional group by a randm digital table, with 56 cases in each group. The observation group was given routine intervention, while the observation group was given intraventricular intracranial pressure monitoring and regulation on the basis of the conventional group. The operation time, blood loss and dosage of mannitol and use time after operation, neurological deficit scores before and 1 month after operation, complications within 1 month after operation, and prognosis were compared between the two groups.

Results

There were no significant differences in the operation time and blood loss between the two groups (P>0.05). The dosage of mannitol in the observation group was less than that in the conventional group (P < 0.05), and the use time was shorter than that in the conventional group (P<0.05). The scores of neurological deficit in the two groups were decreased one month after operation (P<0.05), and the observation group was lower than the conventional group (P<0.05). There was no significant difference in the rates of complications between the observation group and the conventional group within one month after operation (P>0.05), but the total complications rate of the observation group was lower than that in the conventional group (P<0.05). The difference in the distribution of prognosis effect between the two groups was statistically significant (P<0.05), and the poor prognosis rate in the observation group was lower than that in the conventional group (P<0.05).

Conclusion

Intraventricular intracranial pressure monitoring in patients with severe craniocerebral injury can reduce the use of mannitol, reduce the neurological deficit, reduce the total incidence of complications within 1 month after operation, and they have a good prognosis.

Key words: Intraventricular intracranial pressure monitoring, Severe craniocerebral injury, Neurological deficit, Prognosis

Chen Chen, Hong Xu, Zheng Li, Yangyun Han. Study on the application of intraventricular intracranial pressure monitoring in perioperative period of patients with severe craniocerebral injury[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(03): 146-151.

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References 24

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资料		观察组（n=56）	常规组（n=55）	χ²/t值	P值
性别[例（%）]				0.060	0.806
	男	33（58.93）	30（54.55）
	女	23（41.07）	25（45.45）
年龄（岁，Mean±SD）		43.52±7.46	44.28±8.05	0.516	0.607
BMI（kg/m²，Mean±SD）		23.61±3.20	23.89±3.52	0.439	0.662
受伤至入院时间（h，Mean±SD）		1.92±0.35	1.90±0.37	0.293	0.770
病因[例（%）]				1.358	0.269
	高空坠落	13（23.21）	7（12.73）
	暴力打击	7（12.50）	10（18.18）
	交通意外	31（55.36）	36（65.45）
	摔伤	5（8.93）	2（3.64）
严重程度[例（%）]				0.315	0.575
	重型	38（67.86）	40（72.73）
	特重型	18（32.14）	15（27.27）
术前GCS评分（分，Mean±SD）		4.75±0.84	5.01±1.12	1.385	0.169
ASA分级[例（%）]				0.261	0.609
	Ⅰ级	45（80.36）	42（76.36）
	Ⅱ级	11（19.64）	13（23.64）
基线血压（mmHg，Mean±SD）
	收缩压	108.50±10.53	108.22±10.39	0.141	0.888
	舒张压	78.75±8.13	78.62±8.20	0.084	0.933

资料		观察组（n=56）	常规组（n=55）	χ²/t值	P值
性别[例（%）]				0.060	0.806
	男	33（58.93）	30（54.55）
	女	23（41.07）	25（45.45）
年龄（岁，Mean±SD）		43.52±7.46	44.28±8.05	0.516	0.607
BMI（kg/m²，Mean±SD）		23.61±3.20	23.89±3.52	0.439	0.662
受伤至入院时间（h，Mean±SD）		1.92±0.35	1.90±0.37	0.293	0.770
病因[例（%）]				1.358	0.269
	高空坠落	13（23.21）	7（12.73）
	暴力打击	7（12.50）	10（18.18）
	交通意外	31（55.36）	36（65.45）
	摔伤	5（8.93）	2（3.64）
严重程度[例（%）]				0.315	0.575
	重型	38（67.86）	40（72.73）
	特重型	18（32.14）	15（27.27）
术前GCS评分（分，Mean±SD）		4.75±0.84	5.01±1.12	1.385	0.169
ASA分级[例（%）]				0.261	0.609
	Ⅰ级	45（80.36）	42（76.36）
	Ⅱ级	11（19.64）	13（23.64）
基线血压（mmHg，Mean±SD）
	收缩压	108.50±10.53	108.22±10.39	0.141	0.888
	舒张压	78.75±8.13	78.62±8.20	0.084	0.933

组别	例数	手术时间（min）	出血量（mL）	术后甘露醇使用剂量（g）	术后甘露醇使用时间（d）
观察组	56	101.25±14.67	104.25±19.87	300.10±48.05	5.15±1.02
常规组	55	99.82±15.31	107.83±20.65	365.58±52.43	6.85±1.13
t值		0.502	0.931	6.682	8.323
P值		0.616	0.354	<0.001	<0.001

组别	例数	手术时间（min）	出血量（mL）	术后甘露醇使用剂量（g）	术后甘露醇使用时间（d）
观察组	56	101.25±14.67	104.25±19.87	300.10±48.05	5.15±1.02
常规组	55	99.82±15.31	107.83±20.65	365.58±52.43	6.85±1.13
t值		0.502	0.931	6.682	8.323
P值		0.616	0.354	<0.001	<0.001

组别	例数	术前	术后1个月	t值	P值
观察组	56	17.85±4.36	10.36±2.17	11.425	<0.001
常规组	55	17.62±4.28	12.81±2.62	7.155	<0.001
t值		0.280	5.360
P值		0.780	<0.001

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