持续有创颅内压监测对重型颅脑损伤病人救治的临床意义

Application of continuous invasive intracranial pressure monitoring in patients after severe traumatic brain injuries

目的研究重型颅脑损伤病人术后行有创动态颅内压监测的临床意义。方法回顾性分析158例行手术治疗的重型颅脑损伤病例资料,随机分为颅内压监测组与对照组,每组79例。比较两组脱水剂使用剂量、并发症发生率及GOS评分。结果与对照组比较,颅内压监测组甘露醇使用时间和剂量显著减少,而肺部感染、电解质紊乱的发生率明显降低(均P<0.01)。两组GOS评分差异具有统计学意义(P<0.01)。结论持续有创颅内压监测可及时反映颅内压变化,对病人临床救治及判断预后有积极的指导意义。

Objective To investigate clinical significance of invasive dynamic intracranial pressure monitoring in patients with severe traumatic brain injury（STBI）. Methods The clinical data of 158 patients with STBI undergoing surgical treatment were analyzed retrospectively. The 158 patients were randomly divided into two groups： ICP monitoring group（n = 79） and control group（n = 79）. The dehydrating agent dose, incidence of complications and GOS score were compared between monitoring group and control group.Results Compared with the control group, the dose and use duration of mannitol were significantly lower or shorter, and the incidences of pulmonary infection and electrolyte disturbance significantly lower in ICP monitoring group（all P〈0.01）. The difference in GOS score was statistically significant between the two groups（P〈0.01）. Conclusions Continuous invasive ICP monitoring can show ICP change and help to guide the correct clinical treatment, and so as to improve the clinical outcome.