| 杨 俊,王 刚,黄 庆,王长江,彭如臣,张志鹏,张洪兵.CT灌注成像技术用于重型颅脑损伤患者脑室型颅内压探头植入的临床价值评估[J].,2019,19(14):2730-2734 |
| CT灌注成像技术用于重型颅脑损伤患者脑室型颅内压探头植入的临床价值评估 |
| Computed Tomography Perfusion Imaging Evaluation of Ventricle Type of Intracranial Pressure Monitoring in Severe Craniocerebral Injury |
| 投稿时间：2018-12-10 修订日期：2019-01-15 |
| DOI：10.13241/j.cnki.pmb.2019.14.027 |
| 中文关键词: 脑室型颅内压探头 重型颅脑损伤 CT灌注成像 局部脑血流 |
| 英文关键词: Ventricle type of intracranial pressure monitoring Severe craniocerebral injury Computed tomography perfusion imaging Regional cerebral blood flow |
| 基金项目:首都卫生发展科研专项(首发2018-3-7083)；北京市通州区科技计划项目(KJ2018CX005) |
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| 中文摘要: |
| 摘要 目的：探讨CT灌注成像技术用于重型颅脑损伤患者脑室型颅内压(Intracranial Pressure, ICP)探头植入的临床价值。方法：选取60例重型颅脑损伤患者，均行患侧开颅去骨瓣减压和颅内压监测探头置入术。其中，行普通型颅内压监测探头置入术28例，脑室型颅内压监测探头置入术32例。比较两组术后甘露醇应用剂量和应用时间，术后局部脑血流参数区域脑血流量(regional Cerebral Blood Flow, rCBF)、相对脑血容量(relative Cerebral Blood Volume, rCBV)、平均通过时间(Mean Transit Time, MTT)、对比剂达峰时间(time to peak, TTP)恢复情况。结果：脑室型颅内压监测组患者术后应用甘露醇的剂量和天数较普通颅内压监测组明显缩短(P<0.05)，术后3个月随访提示脑室型ICP监测组预后良好比例较普通型ICP组显著增加(P<0.05)。并且螺旋CT灌注成像结果提示脑室型颅内压监测组患者术后局部脑血流参数rCBF、rCBV、MTT、TTP恢复情况明显优于普通型颅内压监测组(P<0.05)。结论：重型颅脑损伤患者应用脑室型颅内监测探头改变了脱水剂在临床应用中的治疗模式，通过螺旋CT灌注成像检测患者损伤部位的rCBF、rCBV、MTT和TTP可评估脑损伤的程度以及预后，对重型颅脑损伤的临床治疗和改善患者预后具有重要意义。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the clinical value of ventricle type of intracranial pressure (ICP) monitoring in severe craniocerebral injury by computed tomography perfusion(CTP) imaging. Methods: The 60 patients with severe craniocerebral injury were performed to the affected side craniotomy with big bone flap decompression and intracranial pressure(ICP) monitoring probe implantation in all patients, including 28 cases with common ICP monitoring probe, and 32 cases with ventricle type of ICP monitoring probe. The dose and application time of mannitol were compared between the two groups, and the regional cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), the mean transit time, (MTT) and the time to peak (TTP) also were compared. Results: The using dosage and time of mannitol in ventricle type of ICP monitoring group was obviously decreased less than Common ICP monitoring group(P<0.05). As follow up after 3 months, the postoperative prognosis in ventricle type of ICP monitoring goup was much better than common ICP monitoring group(P<0.05). The recovery of rCBF, rCBV, MTT and TTP in injured area were much better in entricle type of ICP monitoring goup by CTP. Conclusion: The ventricle type of ICP monitoring probe applied in severe craniocerebral injury can significantly change the treatment modality with mannitol, and is more useful to control the acute ICP and improve the prognosis of patients with severe craniocerebral injury.Analysis of rCBF, rCBV, MTT and TTP in injured area of severe craniocerebral injury have great significance to guide clinical treatment. |
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