NICU外伤性高颅压患者镇痛镇静治疗颅内压监测及疗效观察

Monitoring and Effect Observation of Treating Patients with NICU Traumatic Increased Intracranial Pressure by Pain Relief and Sedation

目的:探讨NICU外伤性高颅压患镇痛镇静治疗对颅内压的影响及整体预后影响。方法:58例外伤性高颅压患者根据镇痛镇静的不同分为治疗组与对照组各29例,两组均采用手术治疗与气管内插管-静吸复合麻醉,术后治疗组给予帕瑞昔布钠和/或咪达唑仑镇痛镇静,对照组仅给常规综合治疗。结果:治疗组术后即刻、4h、12h行VAS评分低于对照组(P<O.05),两组各时间点的镇静评分与昏迷评分都无明显差异,治疗组术后各时间点颅内压均低于对照组(P<0.O5);两组不良反应情况对比无明显差异。结论:帕瑞昔布钠和/或咪达唑仑用于NICU外伤性高颅压患者术后患者镇痛镇静,患者耐受良好,不抑制呼吸,安全性好,并能够通过降低基础代谢率,稳定颅内压,减少患者不良记忆,改善整体预后。

Objective To explore effect of treating patients with NICU traumatic increased intracranial pressure by pain relief and sedation on increased intracranial pressure and holistic prognosis. Methods Totally 48 patients with traumatic increased intracranial pressure were divided into Treatment Group and Control Group （each group 29 cases） by different pain relief and sedation. Both groups received surgical treatment and combined intravenous and inhalation anesthesia with endotrachael intubation. After surgery, Treatment Group was sedated by Parecoxib Na and/or midazolam; on the other hand, Control Group was treated with conventional therapy. Results Treatment Group had lower VAS （P〈0.05） than Control Group immediately, 4hr later, 12hr later. Both showed no significant differences in sedation and coma scores at all time points. Treatment Group had lower intracranial pressures （P〈0.05） than Control Group at all time points. Both groups had no remarkably different adverse reactions. Conclusion Treating patients with NICU traumatic increased intracranial pressure by Parecoxib Na and/or midazolam is characterized by good patients endurance, no inhibition of respiration and good safety. Besides, it reduces patients＇ poor memory and improves holistic prognosis by decreasing basal metabolic rate and stabilizing intracranial pressure.