The Clinical Study Of Postoperative Multimodal Monitoring For Children In Pediatric Neurocritical Unit

Objective: 1)Systematic review the difference prognosis of postoperative multi-modal monitoring and traditional monitoring in Pediatric neurological patients.2)Review the clinical data and perform multivariate logistic regression analysis to find the reason of Internal environment disorder in Pediatric neurological patients;3)Comprehensive discussion the difference of ICU hospital stay,total hospitalization time and 30-day mortality between postoperative multivariate monitoring group and traditional monitoring group in children with severe neurological diseases.Methods: 1)To collect the comparative studys about difference prognosis of postoperative multi-modal monitoring and traditional monitoring in Pediatric neurological patients we conducted by Me SH keyword search for Pubmed,Medline,Cochrane database,Chinese Journal Full-text Database(CNKI),Wanfang Medical Journal Database.Evaluate the methodological quality of the studies,extract valid data,and systematically evaluate the data.2)Retrospective analysis 115 children cases who toked neurosurgery and checked in the ICU of our hospital in January 2015 to March 2016,36 paitients with craniocerebral tumor,25 patients with traumatic brain injury,54 patients with hydrocephalus or toked spinal nerve surgery,perform multivariate logistic regression analysis to find the reason of Internal environment disorder.3)Retrospective analysis 115 children cases who toked neurosurgery and checked in the ICU of our hospital in January 2015 to March 2016,in which the traditional monitoring group had 58 cases before July 2015,the multimodal monitoring group had 57 cases after July 2015.Conducted a cohort Study between the two groups to compare the differences in ICU hospital stay,total hospitalization time and30-day mortality.Results: 1)According to the inclusion criteria,284 articles were included,of which 54 were available in full text.Finally,seven control studies were included in the systematic review.The six kinds of Internal environment disorder include anemia,hypoproteinemia,hypokalemia,hyperchlorosis,acidosis,hyperglycemia.We found the risk factors and independent risk factors of Internal environment disorder in Pediatric neurological patients by analyzing the basic conditions and surgical conditions about the six kinds of Internal environment disorder.Regression analysis showed that the independent influencing factors of hemoglobin were preoperative Hb,the independent influencing factors of albumin were age and preoperative albumin level,the independent influencing factors of serum K + were intraoperative urine output,the independent influencing factors of serum Cl were the preoperative Cl level,the influencing factors of blood gas p H showed: the diagnosis is a protective factor in ethnic minorities relative to the Han and the age,weight,preoperative Hb is a risk factor for acidosis.In this study,we did not find independent influencing factors of serum glucose in the index.In multivariate monitoring group the ICU hospital stay and total hospitalization time were shorter than traditional monitoring group,there are statistical differences(p < 0.05).There was no significant difference in the mortality rate between the two groups.Conclusions: 1)According to the literature,it is concluded that the ICP monitoring group is significantly different from the traditional monitoring group in the prognosis of children with severe neurological complications.2)Our study found that correct the internal environmental abnormalities before operation,shorten the operation time,reduce bleeding can contribute to the stability of the internal environmental in children with severe neurological complications.3)Our study found that multivariate monitoring could reduce ICU hospital stay and total hospitalization time in children with severe neurological complications(p<0.05).There was no significant influences in the mortality rate between the two groups.