颅内压监测在颅脑外伤术后阶梯治疗中的临床意义

Clinical significance of intracranial pressure monitoring in severe traumatic brain injury

目的:动态观察颅内压的变化,探讨颅内压监测在颅脑外伤术后的作用和临床意义。方法:对62例颅脑外伤术后患者进行持续动态颅内压监测,根据监测结果,调整治疗方案并观察其疗效。结果:颅内压与GCS评分呈负相关性(P<0.05);7例再次手术,其中3例血肿发生在术后6 h内;预后良好者52例,预后恶劣者10例,颅内压监测结果与患者预后有关,颅内压越高,预后越差。结论:对颅脑外伤术后患者应及早动态观察颅内压有助于早期发现颅内复发血肿,指导和及时调整治疗措施,降低并发症,提高疗效及估计预后。

Objective： To explore the changes of intracranial pressure（ICP） in severe traumatic brain injury,and to explore the roles of ICP monitoring in treatment of severe traumatic brain injury.Methods： 62 cases with severe traumatic brain injury were performed ICP monitoring.According to the results of ICP monitoring,the treatment methods were adjusted and the treatment effects were observed.Results：The ICP and Glassgow Coma Scale（P〈0.05） were negatively correlated.7 cases had to have reoperations,among which 3 cases had hematoma 6 hours after the operation.52 patients had favourable prognoses,10 patients unfavourable. The prognoses of patients were correlated to the ICP.The higher the ICP,the poorer the prognosis.Conclusion：Timely ICP monitoring in severe traumatic brain injury can help to discover early encephalic hematomas,instruct and adjust the treatment properly;It can also reduce complications,and improve prognoses.