| 赵 永,林 琳,杨建波,向兴刚,买买江·阿不力孜.神经电生理在颅内动脉瘤夹闭术中联合颅内压、脑灌注压监测的应用效果研究[J].,2021,(8):1488-1493 |
| 神经电生理在颅内动脉瘤夹闭术中联合颅内压、脑灌注压监测的应用效果研究 |
| Application Study of Neuroelectrophysiology in Intracranial Aneurysm Clipping Combined with Intracranial Pressure and Cerebral Perfusion Pressure Monitoring |
| 投稿时间：2020-10-21 修订日期：2020-11-15 |
| DOI：10.13241/j.cnki.pmb.2021.08.019 |
| 中文关键词: 神经电生理 颅内动脉瘤夹闭术 颅内压 脑灌注压 |
| 英文关键词: Neuroelectrophysiology Intracranial aneurysm clipping Intracranial pressure Cerebral perfusion pressure |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2015211C117）；新疆医科大学附属中医医院院级课题（ZYY201817） |
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| 中文摘要: |
| 摘要 目的：探讨神经电生理在颅内动脉瘤夹闭术中联合颅内压（ICP）、脑灌注压（CPP）监测的应用效果。方法：选取2018年12月～2020年1月我院进行开颅手术治疗的颅内动脉瘤患者60例，采用简单随机化分组方法分为两组，每组30例。对照组实施颅内动脉瘤夹闭手术，观察组在对照组基础上，术中应用神经电生理、ICP、CPP监测。比较两组动脉瘤夹闭情况，术后第1 d新发神经功能缺损情况，术前、术后1 d、术后3个月格拉斯哥昏迷评分（GCS）、美国国立卫生研究院脑卒中量表（NIHSS）评分及术后3个月预后优良率。结果：两组动脉瘤均完全夹闭，观察组术后第1 d新发神经功能缺损率6.67%（2/30）低于对照组的26.67%（8/30）（P＜0.05）；术后1 d观察组GCS评分高于对照组，NIHSS评分低于对照组（P＜0.05）；排除失访病例后，观察组术后3个月GOS分级、mRS分级优良率分别为88.89%、88.89%，与对照组的88.00%、84.00%比较，差异无统计学意义（P＞0.05）。结论：采用神经电生理联合ICP、CPP监测，能够实时掌握颅内动脉瘤夹闭术患者脑组织血流情况，根据监测结果及时采取相应干预措施，可预防不可逆的脑缺血改变，改善术后早期患者意识状态，减少术后早期神经功能缺损的发生。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application effect of neuroelectrophysiology combined with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring during intracranial aneurysm clipping. Methods: A total of 60 patients with intracranial aneurysms who underwent craniotomy in our hospital from December 2018 to January 2020 were selected, and divided into two groups using a simple randomization method, with 30 cases in each group. The control group was operated by clipping intracranial aneurysms, and the observation group applied electrophysiology, ICP and CPP monitoring on the basis of the control group. The aneurysm clipping status and the new neurological deficit on the 1 d after operation, the Glasgow coma score (GCS) and the National Institutes of Health Stroke Scale (NIHSS) scores before operation, 1 d after operation and 3 months after operation, the prognostic and excellent rates of 3 months after operation were compared between two groups. Results: The aneurysms in both groups were completely clipped, and the rate of new neurological deficits in the observation group was 6.67% (2/30) on the 1 d after operation was lower than 26.67% (8/30) in the control group(P＜0.05). The GCS score of the observation group was higher than that of the control group at 1d after operation, and the NIHSS score was lower than that of control group(P<0.05). After excluding the lost cases, the excellent and good rates of GOS grading and mRS grading in the observation group were 88.89% and 88.89% respectively, which had no statistical significance compared with 88.00% and 84.00% of the control group (P>0.05). Conclusion: Neuroelectrophysiology combined with ICP and CPP monitoring can be used to grasp the blood flow of the intracranial aneurysm clipping patient's brain tissue in real time. According to the monitoring results, timely intervention measures can be taken to prevent irreversible changes in cerebral ischemia, improve the early postoperative consciousness of patients, and reduce the occurrence of early neurological deficit. |
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