连续颅内压监测对脑挫裂伤病人脑水肿控制的影响

EFFECT OF CONTINUOUS INTRACRANIAL PRESSURE MONITORING ON THE CONTROL OF CEREBRAL EDEMA IN PATIENTS WITH CONTUSION AND LACERATION OF BRAIN

目的对比连续颅内压监测条件下按需应用甘露醇与无颅内压监测据经验应用甘露醇控制脑挫裂伤病人脑水肿的效果,探讨控制脑挫裂伤病人脑水肿的策略。方法将40例脑挫裂伤病人随机分为两组,A组放置有创颅内压连续监测装置,颅压超预警线时给予甘露醇,B组无颅内压监测,根据CT表现及临床观察经验性定时定量应用甘露醇。结果两组病人保守治疗成功率及意识状态恢复稳定平均时间差异均无显著性(P>0.05)。结论对中度脑挫裂伤病人应用颅内压监测技术指导控制脑水肿在提高保守治疗成功率及缩短疗程上与经验治疗比较无明显优势。

Objective To compare the efficacy between empirical mannitol therapy and mannitol medication under continuous intracranial pressure monitoring（CIPM） for controlling brain edema in patients suffering from brain contusion and laceration.Methods Forty patients with contusion and laceration of brain were divided into two groups.Group A was placed a CIPM device,mannitol was given when the intracranial pressure surpassed the early warning line;Group B,no CIPM device was installed,mannitol was given based on the experience according to CT manifestations and clinical observation.Results The achievement ratio of conservative treatment and the average time of recovery of conscious state were not significantly different between the two groups（P〈0.05）.Conclusion For improving success of conservative therapy and shorting the course of treatment in moderately brain-injured patients,CIPM is not superior to empirical therapy.