重型颅脑损伤术后无创脑水肿监测的临床应用

目的 探讨无创脑水肿动态监测在重型颅脑损伤患者术后的应用价值。方法 选择54例重型颅脑损伤患者为观察组，选择同期54例脑震荡患者为对照组。观察组采用BORN-BE无创脑水肿动态监护仪连续监测患者开颅手术后双侧大脑半球脑电阻抗（CEI）扰动系数的变化。结果 手术前，观察组手术侧CEI扰动指数较对照组显著降低（P<0.05），非手术侧与对照组无统计学差异（>P>0.05）。术后1、12~14 d，观察组手术侧、观察组非手术侧与对照组CEI扰动指数，两两之间均无统计学差异（P>0.05），但观察组手术侧术后2~11 d CEI扰动指数明显高于对照组（P<0.05）。观察组手术侧cei扰动系数术后2 d逐渐增加，术后4~7="" d达高峰，然后逐渐减低，至术后12="" d与对照组无明显差异（P>0.05）。观察组手术侧CEI扰动系数异常波动共12例，CT示术区脑水肿11例；非手术侧CEI扰动系数异常波动共6例，CT示非手术区域脑水肿4例。结论 CEI扰动系数随重型颅脑损伤患者术后病程推移呈现动态变化，可动态评估患者脑水肿或血肿演变过程，指导临床颅内压处理方法的制定。

Non-invasive monitoring of postoperative cerebral edema in patients with severe craniocerebral trauma

Objective To explore the value of non-invasive monitoring dynamic brain edema to the clinical treatment in the patients with severe craniocerebral trauma. Methods The changes in the cerebral electrical impendence perturbation coefficient (CEIPC) values of the bilateral hemispheres before the operation and 1~14 days after the operation were observed by BOEN-BE non-invasive brain edema monitor in 54 patients with severe craniocerebral trauma. Fifty-four patients with cerebral concussion served as control group. Results CEIPC value in the operated hemisphere before the operation was significantly lower in the observed group than that in the control group (P<0.05). ceipc="" values="" were="" significantly="" higher="" in="" the="" operated="" hemispheres="" observed="" group="" than="" those="" non-operated="" hemisphere="" from="" 2="" to="" 11="" days="" after="" operation="" and="" bilateral="" of="" control="" (P<0.05).>Conclusions The dynamic changes in CEIPC values of the operated hemisphere are parallel to the development of the hemisphere edema after the operation in the patients with severe craniocerebral trauma, in whom CEIPC value is helpful to treating the cerebral edema.