闪光视觉诱发电位无创颅内压监测在重型颅脑损伤治疗中应用效果及其对预后影响.docVIP

闪光视觉诱发电位无创颅内压监测在重型颅脑损伤治疗中应用效果及其对预后影响 　　[摘要] 目的 探讨闪光视觉诱发电位（FVEP）无创颅内压监测在重型颅脑损伤治疗中的应用效果及其对预后的影响。 方法 随机选取桂林医学院附属医院神经外科2013年10月～2014年2月适合行腰穿的患者40例，行FVEP无创颅内压监测测压后立即行腰穿测压，分别记录数值，比较组间差异。另选桂林医学院附属医院神经外科2014年3月～2015年5月格拉斯哥昏迷评分（GCS）3～8分的患者120例，将其分为实验组60例和对照组60例，实验组参考无创颅内压监测、临床表现及影像资料给予治疗，对照组参考临床表现及影像资料传统方法给予治疗，出院后随访3个月，采用格拉斯哥预后评分（GOS），比较组间差异。 结果 前期实验中无创颅内压监测值为（185.75±11.31）mmH2O，腰穿测压值为（182.25±10.56）mmH2O，差异无统计学意义（t=0.272，P0.05），但两者存在相关性（r=0.951，P0.01）；后期实验组与对照组GOS差异有统计学意义（χ2=15.740，P0.01），实验组预后明显优于对照组。 结论 FVEP无创颅内压监测值可准确反映患者颅内压，应用于重型颅脑损伤患者的治疗，可明显改善其预后，且对典型危重颅脑疾病能够准确监测，应用前景广阔。 　　[关键词] 闪光视觉诱发电位；无创颅内压监测；重型颅脑损伤 　　[中图分类号] R651.15 [文献标识码] A [文章编号] 1674-4721（2016）02（c）-0025-04 　　[Abstract] Objective To research the effect of the application of flash visual evoked potentials （FVEP） noninvasive measurement of intracranial pressure in treating severe craniocerebral injury and its influence in the prognosis of the injury. Methods 40 patients appropriated to be carried out lumbar puncture from October 2013 to February 2014 in the Department of Neurosurgery of the Affiliated Hospital of Guilin Medical University， were chosen，and given with FVEP noninvasive intracranial pressure monitoring，and then performing the lumbar puncture measure immediately.The corresponding data was obtained，respectively，the differences between the groups were compared.The in the same hospital，120 patients with the GCS score range from 3 to 8 from March 2014 to May 2015 were collected，and divided into experimental group（60 patients） and control group （60 patients）.The data of non-invasive intracranial pressure monitoring，clinical outcomes and imaging files was collected for the experimental group，and the control group was free of noninvasive intracranial pressure monitoring.The follow-up time was 3 months after lefting the hospital，the GOS score in the difference intergroup was compared. Results In the former experiment the result of the noninvasive measurement of intracranial pressure was （185.75±11.31） mmH