脑室内颅内压持续监测和阶梯式治疗重型颅脑外伤

Continuous monitoring of intracranial pressure and gradient treatment for severe craniocerebral trauma

目的探讨脑室内颅内压持续监测与阶梯式治疗重型颅脑外伤的临床效果。方法重型颅脑外伤患者74例,均进行Spiegelberg脑室探头置入颅内压监测术。根据患者颅内压情况给予相应的阶梯式治疗,观察颅内压控制以及维持脑灌注压的效果。结果本组74例患者中,预后良好55.41%(41/74),中残9.46%(7/74),重残18.92%(14/74),植物状态8.11%(6/74),死亡8.11%(6/74)。结论对重型颅脑外伤患者进行脑室内颅内压监测,并配合阶梯式治疗,能够有效控制颅内压,维持脑灌注压,对降低重型颅脑外伤患者的致残率及致死率均有着较高的临床意义。

Objective To investigate clinical effect by continuous monitoring of intracranial pressure and gradient treatment for severe craniocerebral trauma. Methods A total of 74 patients with severe craniocerebral trauma received monitoring of intracranial pressure by Spiegelberg ventricular probe. Related gradient treatment was provided in accordance with intracranial pressure in patients. Effects of intracranial pressure controlling and cerebral perfusion pressure maintaining were observed. Results Among the 74 patients, 55.41% of them with good prognosis（41/74）, 9.46% with moderate disability（7/74）, 18.92% with severe disability（14/74）, 8.11% with vegetative state（6/74）, and 8.11% with death（6/74）. Conclusion Implement of continuous monitoring of intracranial pressure and gradient treatment for severe craniocerebral trauma patients can effectively control intracranial pressure, and maintain cerebral perfusion pressure. This method contains important clinical significance in reducing disability rate and mortality rate in severe craniocerebral trauma patients.