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重型创伤性脑损伤去骨瓣减压应用改良Paine点穿刺监测脑室内颅内压的优势

田和平 钟琦 王耿焕 周海航

解放军医学杂志2024,Vol.49Issue(2):182-187,6.
解放军医学杂志2024,Vol.49Issue(2):182-187,6.DOI:10.11855/j.issn.0577-7402.1897.2023.0720

重型创伤性脑损伤去骨瓣减压应用改良Paine点穿刺监测脑室内颅内压的优势

Advantages of intraventrilular intracranial pressure monitoring with modified paine point puncture in decompression of severe traumatic brain injury

田和平 1钟琦 1王耿焕 1周海航1

作者信息

  • 1. 嘉兴学院附属第二医院神经外科,浙江嘉兴 314000
  • 折叠

摘要

Abstract

Objective To explore the advantages of modified Paine point puncture for intraventricular intracranial pressure(ICP)monitoring probe implantation during decompressive craniectomy(DC)for severe traumatic brain injury.Methods The clinical data of 48 patients with severe traumatic brain injury admitted from April 2020 to April 2022 in Jiaxing Second Hospital were retrospectively collected.All patients underwent DC combined with ICP monitoring probe implantation.According to different ICP monitoring methods,they were divided into observation group(23 cases)and control group(25 cases).The observation group underwent the implantation of the intracerebroventricular ICP monitoring probe by puncture at the modified Paine point in the DC incision,while the control group underwent implantation of intracerebroventricular ICP monitoring probe by drilling of the skull through contralateral incision of DC at the Kocher point.The preoperative general data,operation time,postoperative mannitol dose and duration,ICP monitoring duration,postoperative rebleeding rate,intracranial infection rate and Glasgow outcome score(GOS)at 3 months after the operation were compared between the two groups.Results There was no statistical difference between the two groups in general data,mannitol dosage,mannitol duration and ICP monitoring duration(P>0.05).The operation time,postoperative rebleeding rate and intracranial infection rate in observation group were lower than those in control group(P<0.05).In the GOS score at 3 months after the operation,there was no statistical difference between the two groups(P>0.05).Conclusions Compared with the traditional implantation of intraventricular ICP monitoring probe through Kocher point through skull drilling with contralateral incision of DC,the implantation of intraventricular ICP monitoring probe through modified Paine point in the DC incision for severe traumatic brain injury can shorten the operation time and lower the postoperative rebleeding rate and intracranial infection rate.

关键词

重型创伤性脑损伤/去骨瓣减压术/脑室内颅内压监测探头置入术/改良Paine点脑室穿刺

Key words

severe traumatic brain injury/decompressive craniectomy/implantation of ventricular intracranial pressure monitoring probe/modified Paine point ventricular puncture

分类

医药卫生

引用本文复制引用

田和平,钟琦,王耿焕,周海航..重型创伤性脑损伤去骨瓣减压应用改良Paine点穿刺监测脑室内颅内压的优势[J].解放军医学杂志,2024,49(2):182-187,6.

基金项目

This work was supported by the Project of Jiaxing Science and Technology Plan(2019AD32193) 嘉兴市科技计划项目(2019AD32193) (2019AD32193)

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