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的应用效果及其对预后的影响

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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，P＞0.05），但两者存在相关性（r=0.951，P＜0.01）；后期实验组与对照组GOS差异有统计学意义（X2=15.740，P＜0.01），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。

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关键词 ：闪光视觉诱发电位, 无创颅内压监测, 重型颅脑损伤

Abstract：Objective To research the effect of the app1ication of f1ash visua1 evoked potentia1s (FVEP) noninvasive measurement of intracrania1 pressure in treating severe craniocerebra1 injury and its inf1uence in the prognosis of the injury. Methods 40 patients appropriated to be carried out 1umbar puncture from October 2013 to February 2014 in the Department of Neurosurgery of the Affi1iated Hospita1 of Gui1in Medica1 University，were chosen，and given with FVEP noninvasive intracrania1 pressure monitoring，and then performing the 1umbar puncture measure immediate1y.The corresponding data was obtained，respective1y，the differences between the groups were compared.The in the same hospita1，120 patients with the GCS score range from 3 to 8 from March 2014 to May 2015 were co11ected，and divided into experimenta1 group (60 patients) and contro1 group (60 patients).The data of non-invasive intracrania1 pressure monitoring，c1inica1 outcomes and imaging fi1es was co11ected for the experimenta1 group，and the contro1 group was free of noninvasive intracrania1 pressure monitoring.The fo11ow-up time was 3 months after 1efting the hospita1，the GOS score in the difference intergroup was compared. Results In the former experiment the resu1t of the noninvasive measurement of intracrania1 pressure was (185.75±11.31) mmH2O，the resu1t of measurement of the 1umbar puncture was (182.25±10.56) mmH2O，resu1ts of the two groups were compared，there was no statistica1 difference (t=0.272，P＞0.05) between the noninvasive intracrania1 pressure monitoring and the 1umbar puncture measure，but they had corre1ation (r=0.951，P＜0.01)，for the fo11owed experiment，the prognostic score of GOS of experimenta1 and contro1 groups werecompared，there was a statistica1 difference (X2=15.740，P＜0.01) in the prognostic score of GOS，demonstrating that the experimenta1 group was obvious priority to the contro1. Conclusion The noninvasive intracrania1 pressure monitoring can ref1ect correct1y the intracrania1 pressure，when app1ied to treat severe craniocerebra1 injury，there wi11 be a dictinct promotion of the prognosis of patients.And it can monitor for the typica1 and crtica1 craniocererbra1 injury accurate1y and succefu11y，its prospct of app1ication is spacious.

Key words： F1ash visua1 evoked potentia1s Noninvasive measurement of intracrania1 pressure Severe craniocerebra1 injury

基金资助:广西壮族自治区卫生厅自筹经费课题（Z2014306）

作者简介: 毕洪伟（1987-），男，河北石家庄人，2013级神经外科专业在读硕士研究生，主要研究脑血管病及颅脑外伤治疗

引用本文:

毕洪伟;唐景峰;黄永旺;杨保华;郑华平;王博. 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的应用效果及其对预后的影响[J]. 中国当代医药, 2016, 23(6): 25-28.
BI Hong-wei1TANG Jing-feng;HUANG Yong-wang;YANG Bao-hua;ZHENG Hua-ping;WANG Bo. Effect of the aPPlication of flash visual evoked Potentials noninvasive measurement of intracranial Pressure in treating severe craniocerebral injury and its influence in the Prognosis of the injury. 中国当代医药, 2016, 23(6): 25-28.

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