摘要
目的研究不同年龄段儿童颅内压及脑灌注压相对正常参考值。方法回顾性分析2015年1月至2022年6月重庆医科大学附属儿童医院神经外科收治的单纯硬膜外血肿行血肿清除及颅内压监测植入患儿,术后每小时监测患儿颅内压和动脉血压,分析不同年龄组的颅内压及脑灌注压随时间、年龄的变化特点,以术后稳定期(手术72 h后)颅内压及脑灌注压值作为儿童相对正常参考值,采用百分位数法分别统计计算颅内压及脑灌注压95%范围作为参考值范围。结果共纳入患儿207例,其中<2岁组25例,2~6岁组82例,>6岁组100例。术后不同年龄组颅内压均经历短暂较低水平后迅速升高,而脑灌注压均经历短暂的较高水平,并且两者在术后12~24 h达到高峰和低谷,于术后72 h逐渐达到稳定范围。手术72 h后颅内压范围:<2岁为3.0~8.0 mmHg,2~6岁为5.0~11.0 mmHg,>6岁为6.0~14.0 mmHg;脑灌注压范围:<2岁50.9~68.7 mmHg,2~6岁55.0~73.3 mmHg,>6岁57.3~79.6 mmHg。结论不同年龄段儿童颅内压和脑灌注压相对正常参考值范围应有所不同,建议随年龄增加而增加。
Objective To study the normal reference values of intracranial pressure and cerebral perfusion pressure in children of different ages.Methods A retrospective study was conducted on the children with simple epidural hematoma who received hematoma removal and implantation for intracranial pressure monitoring in our department from January 2015 to June 2022.The intracranial pressure and arterial blood pressure of the children were monitored per hour after surgery,and the changes in intracranial pressure and cerebral perfusion pressure were analyzed based on time and age in different age groups.The intracranial pressure and cerebral perfusion pressure in stable period(72 h after surgery)were used as the relative normal reference values,and the 95%range of intracranial pressure and cerebral perfusion pressure were calculated statistically by percentile method as the reference range.Results A total of 207 children were included in this study,including 25 in the<2-year-old group,82 in the 2~6-year-old group and 100 in the>6-year-old group.Intracranial pressure in different age groups was increased rapidly after a short period of low level,while cerebral perfusion pressure experienced a short period of high level,and both reached a peak and a trough from 12 to 24 h after surgery,and gradually reached a stable range at 72 h after surgery.The range of intracranial pressure 72 h after surgery was 3.0~8.0 mmHg for the<2-year-old group,5.0~11.0 mmHg for the 2~6-year-old group,and 6.0~14.0 mmHg for the>6-year-old group.Cerebral perfusion pressure range was 50.9~68.7,55.0~73.3,and 57.3~79.6 mmHg,respectively for the above 3 age groups.Conclusion The normal ranges of intracranial pressure and cerebral perfusion pressure are different in children of different ages,and we suggest increasing with age.
作者
陈小兵
纪文元
梁平
翟瑄
周建军
程杨
赵雪灵
CHEN Xiaobing;JI Wenyuan;LIANG Ping;ZHAI Xuan;ZHOU Jianjun;CHENG Yang;ZHAO Xueling(Department of Neurosugery,National Clinical Research Center for Child Health and Disorders,Key Laboratory of Child Development and Disorders of Ministry of Education,Chongqing Key Laboratory of Pediatrics,Children’s Hospital of Chongqing Medical University,Chongqing,400014,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2023年第21期2260-2265,共6页
Journal of Army Medical University
基金
重庆市科卫联合医学科研项目(2021MSXM014)。
关键词
颅内压
脑灌注压
正常值
儿童
intracranial pressure
cerebral perfusion pressure
normal value
children
