无创颅内压监测仪在重症颅脑损伤治疗中的预警作用分析

Analysis on the early-warning function of noninvasive intracranial pressure monitor in the treatment of severe craniocerebral injury

目的 分析无创颅内压监测仪在重症颅脑损伤治疗中的预警作用.方法 选择重症颅脑损伤患者60例,采用无创颅内压监测仪在设置颅内压预警值的情况下连续监测和记录颅内压,密切关注患者颅内压监测变化情况,并给予适当干预措施,将颅内压预警结果与CT复查、GCS评分结果进行对比,采用格拉斯哥评价量表（GOS）评分评估预后.结果 60例患者入院时颅内压均在正常范围内,入院2 h后颅内压均有不同程度升高,升高幅度≥20 mmH2O（1 mmH2O=0.0098 kPa）者46例,CT复查结果显示迟发性血肿挫伤不同程度增大,且颅内压升高与颅内病变、GCS分数改变相符.颅内压预警结果与预后分析结果显示颅内压升高与预后具有显著的相关性;颅内压升高幅度越大,其恢复良好率、轻度缺陷残疾率越低,植物生存率、病死率越高.结论 无创颅内压监测仪对重症颅脑损伤病情变化、治疗指导及预后均有较好的预警作用.

Objective To analyze the early-warning function of noninvasive intracranial pressure monitor in the treatment of severe craniocerebral injury.Methods Sixty patients with severe craniocerebral injury were studied.The intracranial pressure was continuously monitored and recorded with noninvasive intracranial pressure monitor in the case of setting the warning value of intracranial pressure, and operation was carried out at appropriate time.The changes of intracranial pressure were paid close attention to and proper intervention was given, and the results of early warning of intracranial pressure were compared with the results of CT review and GCS score, and the prognosis of the patients was evaluated by the Glasgow Outcome Scale （GOS）.Results On admission, the intracranial pressure of all patients were within the normal range.2 h after admission, the intracranial pressure increased, and the increasing amplitude was larger than 20 mmH2O（1 mmH2O=0.0098 kPa） in 46 cases.CT examination showed that delayed hematoma contusion increased to different degrees, and increased intracranial pressure matched with intracranial lesions and changes of GCS scores.There was significant correlation of results of early warning of intracranial pressure with prognosis.The higher intracranial pressure was, the lower excellent and good rate of recovery and incidence rate of mild disability were, and the higher plant survival rate and mortality rate were.Conclusions The early-warning function of noninvasive intracranial pressure monitor is significant in the condition changes of severe craniocerebral injury, guidance of treatment and prognosis.