颅脑创伤患者的颅内压相关参数与预后的相关性研究

Correlation study of relative parameters of intracranial pressure and prognosis of patient with craniocerebral injury

目的:分析颅脑创伤患者的颅内压相关参数与预后的相关性。方法:回顾性分析80例闭合性颅脑损伤患者临床资料,均予以动脉压和颅内压检测,应用Neumatic DCR数据采集系统对患者的颅内压相关参数进行监测,按照出院时格拉斯哥预后量表(GOS)评分进行分组,Ⅲ~V级为预后良好组(46例),I~Ⅱ级为预后不良组(34例),比较两组颅内压相关参数情况,分析患者预后与颅内压相关参数的相关性。结果:预后良好组的颅脑压力反应指数(PRx)、颅内压(ICP)显著高于预后不良组,差异有统计学意义(t=12.27,t=5.22;P<0.05);而预后良好组的脑灌注压(CPP)水平、颅内压波幅与动脉压波幅的相关系数(IAAC)显著低于预后不良组,差异有统计学意义(t=14.54,t=14.78;P<0.05);两组患者平均年龄、性别、入住神经外科重症监护室(NICU)时长、入院时GCS评分等指标差异均无统计学意义。结论:颅脑损伤患者的预后与PRx、ICP及CPP等颅内压参数为影响颅脑损伤患者预后的危险因素,监测上述指标对于评估颅脑损伤预后具有重要的临床意义。

Objective:To analyze the correlation of relative parameters of intracranial pressure and prognosis of patients with craniocerebral injury.Methods:The clinical data of 80 patients with closed craniocerebral injury were retrospectively analyzed,and all of them underwent the detections of arterial pressure and intracranial pressure.Neumatic DCR system was used to monitor relative parameters of intracranial pressure of patients.According to the scores of Glasgow outcome scale(GOS)when patients leaved hospital,they were divided into favorable prognosis group(GOS III-V,n=46)and poor prognosis group(GOS I-II,n=34).The relative parameters of intracranial pressures of two groups were compared so as to analyze the correlation of the prognosis of patients and the relative parameters of intracranial pressures.Results:The pressure reactivity index(PRx)and intracranial pressure(ICP)of favorable prognosis group were significantly higher than those of poor prognosis group(t=12.27,t=5.22,P<0.05).While the cerebral perfusion pressure(CPP),amplitude of intracranial pressure and ICP-arterial blood pressure wave amplitude correlation(IAAC)of favorable prognosis group were significantly lower than those of poor prognosis group(t=14.54,t=14.78,P<0.05).The average age,gender,duration that stayed in neurosurgery intensive care unit(NICU)and GCS(Glasgow coma scale)scores between the two groups were no statistically significant.Conclusion:The prognosis and the parameters of intracranial pressure that included PRx,ICP,CPP and so on of patients with craniocerebral injury were risk factors that affect prognosis of patients with craniocerebral injury.Therefore,monitoring these indicators has importantly clinical value for assessing prognosis of patients with craniocerebral injury.