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目的分析儿童颅脑创伤后颅内压及脑灌注压随年龄变化的特点。方法纳入2015年1-12月于深圳市盐田区盐港医院,接受有创颅内压监测的颅脑创伤儿童62例为研究对象,按年龄将其划分为<2岁组、2~7岁组、>7岁组,对比各组术后1h、12h、24h、2d、3d时颅内压及脑灌注压的变化特点。结果所有患儿术后颅内压均呈先上升、后下降,最后趋于稳定;脑灌注压均呈先下降、后上升,最后趋于稳定。在术后各时点,>7岁组颅内压均明显高于2~7岁组和<2岁组,在术后24h、2d、3d,>7岁组脑灌注压明显高于2~7岁组和<2岁组,差异有统计学意义(P<0.05)。>7岁组高颅内压持续时间明显长于其他组,低脑灌注压持续时间明显短于其他组,差异有统计学意义(P<0.05)。结论儿童颅脑创伤后颅内压和脑灌注压的变化受年龄的影响,>7岁患儿高颅内压持续时间更长,低脑灌注压持续时间更短;采用有创颅内压监测技术有助于实时反映患儿的颅内压和脑灌注压。
Objective To analyze the characteristics of intracranial pressure and cerebral perfusion pressure changes with age after traumatic brain injury in children. Methods Sixty-two traumatic brain injury patients who underwent invasive intracranial pressure monitoring at Yantian Hospital, Yantian District, Shenzhen from January to December in 2015 were included in this study. They were divided into two groups according to their age, ranging from 2 to 7 years old The changes of intracranial pressure and cerebral perfusion pressure at 1h, 12h, 24h, 2d and 3d after operation in each group were compared. Results All patients had intracranial pressure after surgery first increased, then decreased, and finally stabilized; cerebral perfusion pressure were decreased first, then rose, and finally stabilized. At each time point after operation, the intracranial pressure in> 7-year-old group was significantly higher than that in 2 ~ 7-year-old group and <2-year-old group, and the cerebral perfusion pressure at 24h, 7-year-old group and <2-year-old group, the difference was statistically significant (P <0.05). The duration of high intracranial pressure in> 7 years old group was significantly longer than that in other groups, and the duration of low cerebral perfusion pressure was significantly shorter than that in other groups. The difference was statistically significant (P <0.05). Conclusion The changes of intracranial pressure and cerebral perfusion pressure after craniocerebral trauma in children are affected by the age. The duration of high intracranial pressure and the duration of low perfusion pressure are shorter in children> 7 years of age. Technology helps to reflect real-time intracranial pressure and cerebral perfusion pressure in children.