兰州大学机构库 >第二临床医学院
颅内压联合脑电双频指数和血液标志物监测对重度颅脑损伤患者病情及预后的价值
Alternative TitleThe value of intracranial pressure combined with bispectral Index and blood markers monitoring the condition and prognosis of patients with severe traumatic brain injury
薛鑫
Subtype硕士
Thesis Advisor任海军
2019-04-16
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Degree Discipline外科学
Keyword重型颅脑损伤 颅内压 脑电双频指数 脑损伤血液标志物
Abstract目的:本研究通过动态监测重度颅脑损伤患者颅内压、脑电双频指数和脑损伤标志物浓度的变化,探究其与病情及预后的关系。方法:收集兰州大学第二医院颅脑创伤病区2016年9月~2018年9月收住入院的重度颅脑损伤患者60例,按照GCS评分分为特重度颅脑创伤组20例(GCS3~5)和重度颅脑损伤组40例(GCS6~8),分别于患者伤后7天内连续监测颅内压及脑电双频指数,并于第1、3、5天抽血测定脑损伤血液标志物(NSE、GFAP和UCH-L1),于伤后6个月时进行随访,按照GOS评分将患者分为预后良好组(GOS4~5)和预后不良组(GOS1~3),用SPSS21.0统计软件处理数据。结果:特重组患者的颅内压和血液标志物浓度在伤后7天内明显高于重度组患者,而脑电双频指数低于重度组患者,组间差异存在统计学意义(P<0.05);颅内压和脑电双频指数呈负相关(r=-0.47,P<0.05),即颅内压越高,脑电双频指数越低;颅内压、脑电双频指数和脑血液标志物在预后不良组和预后良好组存在显著差异(P<0.05)。结论:有创颅内压、脑损伤血液标志物和脑电双频指数监测是从不同的生理学角度出发,对颅脑创伤患者病情实时追踪,颅脑损伤程度越严重,颅内压和血液标志物浓度越高而脑电双频指数越低,进而病情升级,与之对应患者的预后也越差。因此,联合颅内压、脑损伤血液标志物和脑电双频指数监测有助于增强对重型颅脑损伤患者病情及预后的判断。
Other AbstractObjective: This study by monitoring in patients with severe traumatic brain injury in bispectral Index、intracranial pressure and the change of the concentration of brain damage markers, to explore its relationship with the condition and prognosis .Methods:To collect the second hospital of lanzhou university, craniocerebral trauma ward in September 2016 to September 2018 in patients with severe traumatic brain injury admitted to the hospital, according to the GCS score divided into highly-severe group 20 people (GCS3~5) and severe group 40 people (GCS6~8), within 7 days after injury in patients with continuous monitoring of intracranial pressure and bispectral Index, and evaluation of patients with GCS score and brain injury blood markers (NSE GFAP and uch-l1), and follow-up was conducted at 6 months after injury. According to GOS scores divided the patients into groups (GOS4~5) good prognosis and bad prognosis group (GOS1~3), with SPSS21.0 statistical software data processing .Results:The intracranial pressure and blood marker concentration of the Highly-severe group were significantly higher than that of the severe group within 7 days after injury, while the bispectral Index was lower than that of the severe group, and the difference between the two groups was statistically significant (P<0.05). There was a negative correlation between intracranial pressure and bispectral Index (r=-0.47,P<0.05), that is, the higher the intracranial pressure was, the lower the bispectral Index was. There were significant differences in intracranial pressure / bispectral Index and cerebral blood markers between the poor prognosis group and the good prognosis group (P<0.05).Conclusion:Invasive intracranial pressure blood/ biomarkers of brain injury and bispectral Index monitoring from a different perspective of physiology, to track the changes of craniocerebral trauma patients in real time, the more severe craniocerebral injury, the higher intracranial pressure and the concentration of blood markers ,at the same time, bispectral Index is lower, and the prognosis is poorer. therefore, combined intracranial pressure /blood biomarkers of brain injury and bispectral Index monitoring  enhance the judgment of the condition and prognosis of patients with severe craniocerebral injury.
Pages46
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/338680
Collection第二临床医学院
Affiliation
第二临床医学院
First Author AffilicationSecond Clinical School
Recommended Citation
GB/T 7714
薛鑫. 颅内压联合脑电双频指数和血液标志物监测对重度颅脑损伤患者病情及预后的价值[D]. 兰州. 兰州大学,2019.
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