持续有创颅内压监测在重型颅脑损伤术后的临床意义

Significance of Invasive Continuous Intracranial Pressure Monitoring in the Treatment of Severe Traumatic Brain Injury in the Postoperative

目的:探讨持续有创颅内压(ICP)监测在重型颅脑损伤术后的临床意义。方法:对2013年10月-2017年4月在武汉科技大学附属天佑医院神经外科住院的180例行有创颅内压监测的重型颅脑损伤患者,从其颅内压变化和根据监测指导治疗及预后方面进行回顾性分析。结果:进行有创持续颅内压监测的180例患者中,110例颅内压正常或轻度升高者减少脱水剂量,其中35例正常颅内压者中,34例预后良好,重残1例;75例轻度颅高压者中,预后良好65例,重残7例,植物状态2例,死亡1例。70例颅内压中重度升高者加大脱水剂量,52例中度颅高压者中,预后良好32例,重残7例,植物状态5例,死亡8例;18例重度颅高压者中,预后良好0例,植物状态1例,死亡17例。结论:持续有创颅内压监测在重型颅脑损伤中不仅可以指导治疗,而且可以判断预后,具有较好的临床价值。

Objective： To investigate the value of invasive continuous intracrania[ pressure（ICP） monitoring in the treatment of severe traumatic brain injury in the postoperative.Method： Clinical data of 180 patients with intracranial pressure monitoring were retrospectively reviewed from the intracranial pressure change, treatment and prognosis were retrospectively analyzed.Result： With^the continuous intracranial pressure monitoring in 180 patients, 110 patients with normal or slightly elevated intracranial pressure were given reduced dosage of dehydrant, Among them 35 cases of normal intracranial pressure, 34 patients with good prognosis, heavy damage in 1 case, while 70 patients who had moderate to severe intracranial pressure were given increased dosage of dehydrant, 52 cases of moderate cranial pressure, good prognosis 32 cases, 7 cases of heavy residues, vegetative state in 5 cases, 8 cases of death, 18 cases of severe cranial pressure, 0 case with good prognosis, vegetative state in 1 case, 17 cases of death.Conclusion： Continuous invasive intracranial pressure monitoring in severe head injury can not only guide the treatment and but also judge prognosis, has good clinical value.