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Codman MicroSensor™ ICP 设备的并发症和位置:549 例患者和 650 个传感器的分析。

The complications and the position of the Codman MicroSensor™ ICP device: an analysis of 549 patients and 650 Sensors.

机构信息

Department of Pharmacology and Clinical Neuroscience, Division of Neurosurgery, Umeå University, 901 85, Umeå, Sweden,

出版信息

Acta Neurochir (Wien). 2013 Nov;155(11):2141-8; discussion 2148. doi: 10.1007/s00701-013-1856-0. Epub 2013 Sep 10.

Abstract

BACKGROUND

Complications of and insertion depth of the Codman MicroSensor ICP monitoring device (CMS) is not well studied.

OBJECTIVE

To study complications and the insertion depth of the CMS in a clinical setting.

METHODS

We identified all patients who had their intracranial pressure (ICP) monitored using a CMS device between 2002 and 2010. The medical records and post implantation computed tomography (CT) scans were analyzed for occurrence of infection, hemorrhage and insertion depth.

RESULTS

In all, 549 patients were monitored using 650 CMS. Mean monitoring time was 7.0 ± 4.9 days. The mean implantation depth was 21.3 ± 11.1 mm (0-88 mm). In 27 of the patients, a haematoma was identified; 26 of these were less than 1 ml, and one was 8 ml. No clinically significant bleeding was found. There was no statistically significant increase in the number of hemorrhages in presumed coagulopathic patients. The infection rate was 0.6 % and the calculated infection rate per 1,000 catheter days was 0.8.

CONCLUSION

The risk for hemorrhagic and infectious complications when using the CMS for ICP monitoring is low. The depth of insertion varies considerably and should be taken into account if patients are treated with head elevation, since the pressure is measured at the tip of the sensor. To meet the need for ICP monitoring, an intraparenchymal ICP monitoring device should be preferred to the use of an external ventricular drainage (EVD).

摘要

背景

Codman MicroSensor ICP 监测仪(CMS)的并发症和插入深度尚未得到充分研究。

目的

在临床环境中研究 CMS 的并发症和插入深度。

方法

我们确定了所有在 2002 年至 2010 年间使用 CMS 装置监测颅内压(ICP)的患者。分析了病历和植入后计算机断层扫描(CT)扫描,以确定感染、出血和插入深度的发生情况。

结果

共监测了 549 例患者的 650 个 CMS。平均监测时间为 7.0±4.9 天。平均植入深度为 21.3±11.1mm(0-88mm)。在 27 例患者中发现血肿,其中 26 例血肿小于 1ml,1 例血肿为 8ml。未发现有临床意义的出血。在假定凝血功能障碍的患者中,出血的数量没有统计学显著增加。感染率为 0.6%,每 1000 个导管日的感染率为 0.8。

结论

使用 CMS 监测 ICP 时,出血和感染并发症的风险较低。插入深度差异很大,如果患者接受头部抬高治疗,应考虑这一点,因为压力是在传感器尖端测量的。为了满足 ICP 监测的需求,应优先选择脑内 ICP 监测装置,而不是使用外部脑室引流(EVD)。

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