| 乔建新,王静辉,李媛莉,曹 兵,刘 明,刘熙鹏.持续颅内压监测对大面积脑梗死外科治疗预后的应用价值[J].,2020,(8):1545-1548 |
| 持续颅内压监测对大面积脑梗死外科治疗预后的应用价值 |
| The Application Value of Continuous Intracranial Pressure Monitoring in the Prognosis of Surgical Treatment of Large Area Cerebral Infarction |
| 投稿时间：2019-11-06 修订日期：2019-11-30 |
| DOI：10.13241/j.cnki.pmb.2020.08.032 |
| 中文关键词: 颅内压 持续颅内压监测 大面积脑梗死 预后 应用价值 |
| 英文关键词: Intracranial pressure Continuous intracranial pressure monitoring Large area cerebral infarction Prognosis Application value |
| 基金项目:河北省医学科学研究重点课题计划项目（20180814）；张家口市科学技术研究与发展计划项目（132112D） |
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| 中文摘要: |
| 摘要 目的：探讨持续颅内压（ICP）监测对大面积脑梗死外科治疗预后的应用价值。方法：选取2013年3月至2018年3月期间在我院接受治疗的大面积脑梗死患者100例作为研究对象，所有患者经去骨瓣减压术后行ICP监测和生命体征监测，通过结果分为：低压组62例（2.70kPa≤ICP＜5.30kPa )，高压组38例（ICP≥5.30 kPa）。记录患者ICP监测数值，接收者操作特征（ROC）曲线分析患者预后情况，对患者进行术后3个月内随访，了解患者平常活动能力进行判断预后的状况。观察ICP与预后的相关性。结果：两组患者性别、年龄、室速、室性早搏、糖尿病、高血压病、脑卒中、高脂血症、风心病、冠心病、扩张性心肌病、既往心肌梗死、肥厚性心肌病、甲亢性心脏病等资料比较差异无统计学意义（P>0.05）。低压组患者中预后良好的ICP监测值显著低于预后不良者（P＜0.05），高压组中预后良好的ICP监测值显著低于预后不良者（P＜0.05）。ICP预测大面积脑梗死外科治疗预后的ROC曲线面积0.704，采用最大约等指数计算得出ICP预测大面积脑梗死外科治疗预后的最大AUC面积相应参数截止值为4.89，其中敏感度为0.435，特异性为0.896。结论：持续ICP监测结果显示ICP值越小，患者的预后就越好，ICP值越高，患者的预后越差。ICP监测对大面积脑梗死外科治疗的预后具有预测价值，对判断和改善预后能起到有效帮助，值得在临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application value of continuous intracranial pressure (ICP) monitoring in the prognosis of surgical treatment of large area cerebral infarction. Methods: From March 2013 to March 2018, 100 patients with large area cerebral infarction who were treated in our hospital were selected as the study objects. All patients underwent ICP monitoring and vital signs monitoring after decompressive operation. According to the results, they were divided into the low pressure group with 62 patients (2.70kPa≤ICP<5.30kPa) and the high pressure group with 38 patients (ICP≥5.30 kPa). ICP monitoring value was recorded, receiver operating characteristic (ROC) curve was used to analyze the prognosis of the patients, and the patients were followed up within 3 months after the operation to understand the prognosis of the patients' normal activity ability. The correlation between ICP and prognosis was observed. Results: There was no significant difference in gender, age, ventricular tachycardia, premature beat, diabetes, hypertension, stroke, hyperlipidemia, rheumatic heart disease, coronary heart disease, dilated cardiomyopathy, previous myocardial infarction, hypertrophic cardiomyopathy and hyperthyroid heart disease between the two groups (P>0.05). The ICP monitoring value of the patients with good prognosis in the low pressure group was significantly lower than that of the patients with poor prognosis (P<0.05). The ICP monitoring value of the patients with good prognosis in the high pressure group was significantly lower than that of the patients with poor prognosis (P<0.05). The area of ROC curve predicted by ICP was 0.704. Calculated the maximum area of AUC predicted by ICP for surgical treatment of massive cerebral infarction by using the most approximate index, and the corresponding cut-off value of the parameter was 4.89, sensitivity was 0.435, specificity was 0.896. Conclusion: The results of continuous ICP monitoring showed that the smaller the ICP value, the better the prognosis of the patients. The higher the ICP value, the worse the prognosis of the patients. ICP monitoring has a predictive value for the prognosis of surgical treatment of large scale cerebral infarction, and it can play an effective role in judging and improving the prognosis, which is worth popularizing in clinical application. |
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