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| 动态颅内压监测在占位性小脑梗死枕下后颅窝减压术中的应用 | |
| 引用本文： | 赵端允,张海兵,李光宏,王洪波. 动态颅内压监测在占位性小脑梗死枕下后颅窝减压术中的应用[J]. 国际医药卫生导报, 2022, 28(9): 1283-1287. DOI: 10.3760/cma.j.issn.1007-1245.2022.09.023 |
| 作者姓名： | 赵端允 张海兵 李光宏 王洪波 |
| 作者单位： | 菏泽市立医院神经外科，菏泽 274000 |
| 摘 要： | 目的:探讨动态颅内压监测在占位性小脑梗死枕下后颅窝减压手术中的应用，分析颅内压变化规律及其对预后的影响。方法:回顾性分析了2016年10月至2020年10月，菏泽市立医院22例动态颅内压监测联合枕下后颅窝减压术治疗的占位性小脑梗死患者，其中男11例，女11例，年龄28～79（56.4±13.5）岁。手术时分别在颅内压监... |
| 关 键 词： | 小脑梗死 去骨瓣减压 颅内压监测 骨窗面积 |
| 收稿时间： | 2022-01-07 |
Application of dynamic intracranial pressure monitoring in suboccipital decompressive craniectomy for space-occupying cerebellar infarction |
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| Zhao Duanyun,Zhang Haibing,Li Guanghong,Wang Hongbo. Application of dynamic intracranial pressure monitoring in suboccipital decompressive craniectomy for space-occupying cerebellar infarction[J]. International Medicine & Health Guidance News, 2022, 28(9): 1283-1287. DOI: 10.3760/cma.j.issn.1007-1245.2022.09.023 | |
| Authors: | Zhao Duanyun Zhang Haibing Li Guanghong Wang Hongbo |
| Affiliation: | Departmentof Neurosurgery, Heze Municipal Hospital, Heze 274000, China |
| Abstract: | Objective To explore the application of dynamic intracranial pressure (ICP)monitoring in suboccipital decompressive craniectomy (SDC) for space-occupyingcerebellar infarction, and investigate the ICP changes and their impact on thepatients' prognosis. Methods Twenty-two patientswith space-occupying cerebellar infarction treated with SDC and dynamic ICPmonitoring in Heze Municipal Hospital from October 2016 to October 2020 wereretrospectively analyzed, including 11 males and 11 females, and they were28-79 (56.4±13.5) years old. When the ICP monitoring probe was put in, beforedecompressive craniectomy and after the cerebrospinal fluid was released, andwhen the surgery was over, the ICP's were measured, and recorded as ICP1, ICP2,and ICP3. The difference between ICP2 and ICP3 was recorded as ΔICP. After thesurgery, the ICP was continuously and dynamically monitored, and the ICP changeand its relation with prognosis were analyzed. Independent-sample t test, paired t test, and Pearson correlation analysis were applied. Results The ICP1, ICP2, ICP3, and peak ICP were(22.3±4.3), (20.3±3.9), (15.7±3.8) and (19.4±5.2) mmHg (1 mmHg=0.133 kPa), witha statistical difference between ICP2 and ICP3 (P<0.01), and the ΔICP was (4.6±1.9) mmHg. The craniectomy areawas (22.5±1.6) cm2, and the ΔICP had no correlation with it (P=0.17). By the end of the follow-upperiod, 18 patients survived, and 4 patients died. The score of Glasgow OutcomeScale (GOS) in the patients who survived was (3.9±1.5), and 16 patients hadhigh survival quality, and their scores of GOS ≥ 4. The peak ICP and cumulative time forpostoperative ICP to exceed the threshold (CTET) had impact on the patients'prognosis (r=0.31, P<0.01). Conclusion ICP monitoring is valuable for SDC in the treatment of space-occupyingcerebellar infarction and may predict the patients' prognosis. |
| Keywords: | Cerebellar infarction Decompressive craniectomy Intracranial pressure monitoring Craniectomy area |
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