持续有创颅内压监测下丙泊酚对重型颅脑损伤治疗的影响

Effect of Propofol on the Treatment of Severe Traumatic Brain Injury with Continuous Invasive Intracranial Pressure Monitoring

目的在持续有创颅内压的监测下,研究丙泊酚对重型颅脑损伤治疗的影响.方法：将重型颅脑损伤患者32例分为丙泊酚组和对照组.所有患者均采用有创ICP监护.丙泊酚组持续静脉泵注丙泊酚,根据病情维持1~4 d,其余治疗同对照组.对照组采用神经外科常规治疗方法.观察GCS评分变化,ICP变化率,甘露醇用量及并发症的发生率等.结果：两组1周内的GCS评分变化差异无统计学意义（P 〉 0.05）.在3 d及4 d时,丙泊酚组的ICP下降幅度显著大于对照组.2、3、4 d丙泊酚组的甘露醇用量明显少于对照组（P〈0.05）.丙泊酚组和对症组都未发现严重的局部及全身不良反应.结论：丙泊酚的应用可在-定时间内降低患者的ICP,从而减少甘露醇的使用量.但对患者的短期预后没有明显帮助.

Objective To investigate the clinical significance of propofol on the treatment of severe traumatic brain injury withcontinuous invasive intracranial pressure monitoring. Methods： 32 patients were randomly divided into 2 groups with invasiveintracranial pressure monitoring. In propofol group, patients were given continuous intravenous pumping of propofol for 1-4 days.Patients in the control group were given a regular treatment of neurosurgery. Close observation of GCS scoring, ICP change rate, totalamount of mannitol and complication was carried out. Results： Two groups had no significant difference in GCS scoring in 1 week（P 〉0.05）. On the 3rd day and 4th day, the decrease of ICP of propofol group was greater than that of control group. The total amount ofmannitol of experiment group was obviously smaller than that of control group on the 2nd day, the 3rd day and 4th day（P〈 0.05）.Conclusion： In a certain period of time, propofol would help reduce the ICP, thus decreasing the total amount of mannitol. However, itshowed no significance in short-term prognosis.