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目的探讨无创颅内压监测仪在颅脑损伤中的临床应用经验。方法选取50例颅脑损伤患者并分成3组,其中急诊手术组20例,颅内血肿保守治疗后加重再手术组10例,保守治疗组20例,另选正常对照组20例。前两组分别于术前、术后3 d和7 d监测颅内压闪光视觉诱发电位(FVEP)值,后两组分别于入院第1天、4天和7天监测颅内压FVEP值,共3次,每次监测颅内压之后即刻腰穿测定颅内压进行对照。比较二者之间差别。无创颅内压监测仪监测颅内压时,15 min内连续3次测定FVEP值并记录,取平均值,分析所得240幅FVEP的N2波,总结N2波波形特点,比较同一测试者随着颅内压的改变FVEP值的变化情况。结果FVEP值和腰穿结果基本接近,用等效检验方法比较,结果提示二者之间等效,可以准确反应出颅内压的改变趋势。术前和术后颅内压改变较大.颅内压越高N2波潜伏期越长。结论仪器所测颅内压和腰穿测得的颅内压结果相比较,二者之间无差别。FVEP值和颅内压变化成正相关。无创颅内压监测仪可以作为临床诊断和治疗的辅助工具,其操作简单,安全可靠。
Objective To explore the clinical application experience of noninvasive intracranial pressure monitor in craniocerebral injury. Methods Fifty patients with craniocerebral injury were selected and divided into three groups, of which 20 were in emergency operation group, 10 in reoperation group, 20 in conservative treatment group and 20 in normal control group after conservative treatment of intracranial hematoma. The first two groups were observed preoperatively, 3 d and 7 d postoperative intracranial pressure flash visual evoked potential (FVEP) value, the latter two groups were admitted on the first day, 4 days and 7 days monitoring intracranial pressure FVEP value, A total of 3 times, each monitoring intracranial pressure immediately after lumbar puncture intracranial pressure control. Compare the difference between the two. Noninvasive intracranial pressure monitor monitoring intracranial pressure, 15 min, 3 consecutive determination of FVEP value and record, averaging, analysis of the resulting 240 FVEP N2 wave, summarize the characteristics of N2 waveform, compared with the same test with the skull Changes in internal pressure FVEP values change. Results FVEP value and lumbar puncture results are basically close, with the equivalent test method comparison, the results suggest that the equivalent between the two, can accurately reflect the changing trend of intracranial pressure. Preoperative and postoperative changes in intracranial pressure larger.Novascular brain pressure higher N2 latency longer. Conclusion There is no difference between the intracranial pressure measured by the instrument and the intracranial pressure measured by lumbar puncture. FVEP values and changes in intracranial pressure is positively correlated. Noninvasive intracranial pressure monitor can be used as ancillary tools for clinical diagnosis and treatment, its operation is simple, safe and reliable.