Khan S H, Kureshi I U, Mulgrew T, Ho S Y, Onyiuke H C
Department of Neurosurgery Head Injury Program, Hartford Hospital, University of Connecticut School of Medicine, Hartford, USA.
Acta Neurochir Suppl. 1998;71:50-2. doi: 10.1007/978-3-7091-6475-4_16.
Intraventricular catheters (IVC) and Intraparenchymal fiberoptic catheters (IPC) are the prevalent methods of intracranial pressure (ICP) monitoring. This study assesses the complications caused by either method. Previous studies have shown a higher complication rate with IVC. In 156 consecutive patients, with IVC (n = 104) or IPC (n = 52) insertion, the demographics, Glasgow coma score (GCS), ICP, duration of monitoring, changes in monitoring device, complications and computerized tomography findings, were recorded. The patients were categorized into severe (GCS 3-8), moderate (GCS 9-12) and mild (GCS 13-15) groups. A retrospective, comparative analysis of both techniques was conducted, using Kruskal-Wallis one way analysis of variance with chi square approximation and Mann-Whitney U tests. The use of IPC at 86.5% predominated in patients with GCS 3-8, while IVC at 81.4% and 92% prevailed in GCS groups 9-12 and 13-15, respectively (p = 0.000). 43.2% IVC were used for 10+ days and 25.9% for 1-3 days, while 80% of IPC were used for less than 6 days (p = 0.000). The complication rate for IVC and IPC was 25% vs 4.4% (p = 0.000). The infection rate was 4.4% and 0.6% (p = 0.1) while, inadvertent removal 4.4% vs 1.2% (p = 0.4), respectively. Malpositions occurred only with IVC (20.1%). All documented complications were without untoward clinical sequelae. We conclude that, IVC remains comparable to IPCs in complications.
脑室内导管（IVC）和脑实质内光纤导管（IPC）是颅内压（ICP）监测的常用方法。本研究评估了这两种方法所引起的并发症。既往研究表明IVC的并发症发生率更高。在156例连续接受IVC（n = 104）或IPC（n = 52）置入的患者中，记录了人口统计学资料、格拉斯哥昏迷评分（GCS）、ICP、监测持续时间、监测设备的更换情况、并发症以及计算机断层扫描结果。患者被分为重度（GCS 3 - 8）、中度（GCS 9 - 12）和轻度（GCS 13 - 15）组。采用Kruskal - Wallis单向方差分析及卡方近似法和Mann - Whitney U检验对这两种技术进行回顾性比较分析。在GCS 3 - 8的患者中，86.5%的患者使用IPC，而在GCS 9 - 12组和13 - 15组中，分别有81.4%和92%的患者使用IVC（p = 0.000）。43.2%的IVC使用时间为10天以上，25.9%的使用时间为1 - 3天，而80%的IPC使用时间少于6天（p = 0.000）。IVC和IPC的并发症发生率分别为25%和4.4%（p = 0.000）。感染率分别为4.4%和0.6%（p = 0.1），意外拔除率分别为4.4%和1.2%（p = 0.4）。仅IVC出现了置管位置不当的情况（20.1%）。所有记录的并发症均未导致不良临床后果。我们得出结论，IVC在并发症方面与IPC相当。
