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(cè)在兒童重型顱腦創(chuàng)傷(sTBI)中的應(yīng)用價(jià)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(cè)將其分為監(jiān)測(cè)組(80例)與對(duì)照組(78例)。監(jiān)測(cè)組術(shù)后24h內(nèi)安裝有創(chuàng)ICP監(jiān)測(cè),并根據(jù)ICP水平采取相應(yīng)處理措施,對(duì)照組通過(guò)臨床癥狀并根據(jù)經(jīng)驗(yàn)判斷是否需要復(fù)查頭顱CT與調(diào)整治療方案,傷后3個(gè)月按照哥拉斯哥預(yù)后評(píng)分(GOS)判斷患兒預(yù)后并進(jìn)行比較分析。同時(shí),比較監(jiān)測(cè)組不同ICP水平患兒預(yù)后。結(jié)果監(jiān)測(cè)組預(yù)后良好率為61.2%,對(duì)照組預(yù)后良好率為41.0%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。監(jiān)測(cè)組不同ICP水平患兒病死率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 sTBI患兒及時(shí)安裝有創(chuàng)ICP監(jiān)測(cè)能夠動(dòng)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(diǎn)實(shí)驗(yàn)室/兒科學(xué)重慶市重點(diǎn)實(shí)驗(yàn)室/重慶市兒童發(fā)育重大疾病診治與預(yù)防國(guó)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(diǎn)實(shí)驗(yàn)室/兒科學(xué)重慶市重點(diǎn)實(shí)驗(yàn)室/重慶市兒童發(fā)育重大疾病診治與預(yù)防國(guó)際科技合作基地新生兒科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(81401236)
【分類號(hào)】：R726.5

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