颅内压监测在颅脑外伤术后的应用

Application of Intracranial Pressure Monitoring in Craniocerebral Trauma

目的对颅脑外伤术后患者动态颅内压(ICP)变化进行总结,分析颅内压监测在颅脑外伤术后治疗中的应用及对预测患者预后的临床意义。方法收集该院颅脑外伤手术且术后行ICP监测的患者60例,采用侧脑室导管测压法或硬脑膜下压力测定法对患者进行动态颅内压监测,通过监测结果指导临床治疗,并对监测结果对患者预后进行初步判断。结果短期内颅内压升高对预测术后再出血有积极意义。对患者术后第1天脱水前ICP与6个月后的预后关系进行观察,发现颅内压越高,其预后就越差。持续颅内压重度升高是患者预后较差的指标。结论动态颅内压监测不仅有助于及早发现颅内再出血,还可准确评估预后,同时对治疗措施进行有效指导和调整,起到减少术后并发症,提高治疗效果的作用。

Objective To summarize the change of dynamic intracranial pressure （ICP） in patients after craniocerebral trauma operation, analyze the clinical significance of ICP monitoring for the therapy after craniocerebral trauma operation and predicting the prognosis of the patients. Methods 60 cases with ICP monitoring after craniocerebral trauma operation in our hospital were selected. Lateral ventricular catheter pressure measuring method or subdural pressure measurement was used to measure the dynamic intracranial pressure of the patients. And the results of monitoring were used to guide the clinical treatment and judge the prognosis of the patients preliminarily. Results Elevated ICP in short term has a positive significance for predicting postoperative rebleeding. The relationship between the ICP before dehydration at the first day after surgery in patients and the prognosis 6 months later was observed and it was found that the higher the intracranial pressure, the worse the prognosis. The persistent severe increase of ICP in patients is the index of poor prognosis. Conclusion Dynamic monitoring of intiacranial pressure can not only help early detect intracranial rebleeding, but also accurately assess the prognosis, as well as guide and regulate the treatment measures effectively so as to reduce the postoperative complications and improve the treatment effect.