有创颅内压监测应用于重型颅脑损伤术后的临床意义

Clinical significance of invasive intracranial pressure monitoring applied after severe craniocerebral injury surgery

目的探讨有创颅内压监测应用于重型颅脑损伤术后的临床意义。方法 94例手术治疗的重型颅脑损伤患者,采用随机数字表法分为监测组与对照组,每组47例。对照组通过常规的生命体征的变化实施治疗,监测组患者进行动态颅内压(ICP)监测,并根据ICP监测以及患者的生命体征,指导脱水剂的使用。对比分析两组治疗前后的格拉斯哥昏迷(GCS)评分和不良事件的发生状况。结果监测组和对照组在治疗前GCS评分差异无统计学意义(P>0.05),而治疗后两组的GCS评分均显著升高,差异有统计学意义(P<0.001),并且监测组的GCS评分显著高于对照组,差异具有统计学意义(t=7.65,P<0.001)。监测组的不良事件发生率显著低于对照组,差异具有统计学意义(χ2=5.303,P=0.021<0.05)。结论对重型颅脑损伤术后患者进行动态ICP监测,具有良好的临床指导效果,减少不良事件的发生。

Objective To investigate the clinical significance of invasive intracranial pressure monitoring applied after severe craniocerebral injury surgery.Methods A total of 94 severe craniocerebral injury patients with surgical treatment were divided by random number table into monitoring group and control group, with 47 cases in each group. The control group received treatment through conventional vital signs change, and the monitoring group received dynamic intracranial pressure （ICP） monitoring, along with dehydrating agent applied under guidance by ICP monitoring and vital signs. Glasgow coma scale （GCS） scores and incidences of adverse reactions between the two groups before and after treatment.Results The was no statistically significant difference of GCS scores between the monitoring group and control group before treatment （P〉0.05）, while both groups had obviously increased GCS score after treatment, and their difference had statistical significance （P〈0.001）. The monitoring group had much higher GCS score than the control group, and the difference had statistical significance （t=7.65,P〈0.001）. The monitoring group had obviously lower incidences of adverse reactions than the control group, and their difference had statistical significance （χ^2=5.303,P=0.021〈0.05）.Conclusion Implement of dynamic ICP monitoring contains good effect in clinical guidance for severe craniocerebral injury patients after surgery, and this method can reduce incidence of adverse reactions.