颅内压监测与常规监测在重症颅脑外伤中应用效果对比分析

Comparative analysis of intracranial pressure monitoring and routine monitoring in severe craniocerebral trauma

目的探讨颅内压监测与常规监测在重症颅脑外伤中应用效果对比分析。方法将2015年10月~2017年10月在我院神经外科治疗的70例重症颅脑外伤患者随机分为两组,对照组采用常规监测,观察组采用颅内压监测,比较两组患者的临床疗效、并发症发生率、入院至手术时间、术后甘露醇用量及使用时间。结果观察组治疗有效率为91.43%、预后良好率为60%,对照组治疗有效率为77.14%、预后良好率为42.86%,差异有统计学意义(P<0.05);观察组肺部感染、颅内感染、颅内血肿、电解质紊乱、肾功能衰竭、脑疝等并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组入院至手术时间、术后甘露醇用量、甘露醇使用时间、住院时间与对照组相比明显较少,差异有统计学意义(P<0.05)。结论颅内压监测在重症颅脑外伤中应用效果显著,能及时反映患者病情变化,有效提升手术疗效及预后,减少术后甘露醇使用剂量及时间,降低术后并发症发生率,具有积极的临床意义。

Objective To investigate the effect of intracranial pressure monitoring and routine monitoring in severe craniocerebral trauma. Methods Seventy patients with severe craniocerebral trauma who were treated in our hospital from October 2015 to October 2017 were randomly divided into two groups. The control group was given routine monitoring, while the observation group was given intracranial pressure monitoring. The clinical efficacy, incidence of complications, time from admission to operation, postoperative mannitol dosage and use time of the two groups were compared. Results The effective rate of the observation group was 91.43%, the good prognosis was 60%, the effective rate of the control group was 77.14%, the good prognosis was 42.86%, the difference was statistically significant（P〈0.05）. The incidence of complications such as pulmonary infection, intracranial infection, intracranial hematoma, electrolyte disturbance, renal failure and cerebral hernia in the observation group was significantly lower than that in the control group（P〈0.05）. The time from admission to operation, the dosage of mannitol, the time of mannitol use and the time of hospitalization of the observation group were less than those of the control group, and the difference was statistically significant（P〈0.05）. Conclusion The effect of intracranial pressure monitoring in severe craniocerebral trauma is significant. It can reflect the change of the patient＇s condition in time, improve the curative effect and prognosis effectively, reduce the dosage and time of mannitol after operation, reduce the incidence of postoperative complications, and have positive clinical significance.