持续颅内压监测在重型颅脑损伤患者治疗中的应用价值分析

Analysis of the Application Value of Continuous Intracranial Pressure Monitoring in the Treatment of Patients with Severe Head Injury

目的研究持续颅内压监测在重型颅脑损伤患者术后治疗中的价值。方法回顾性分析2017年1月—2020年1月合肥市第二人民医院神经外科的60例重型颅脑损伤手术的患者,以是否施行颅内压探头置入术,分为监测组(n=30)和对照组(n=30),对照组术后根据患者的骨窗张力、神志瞳孔、CT变化等判断颅内压变化,决定治疗方案;监测组术后则进行持续颅内压监测,根据客观记录的颅内压数值,决定治疗方案。根据格拉斯哥昏迷指数及格拉斯哥预后评分,对比分析两组患者的预后。结果监测组患者预后情况优于对照组,差异有统计学意义(χ^(2)=10.689,P<0.05);监测组术后1周、术后2周及出院时GCS评分均高于对照组,差异有统计学意义(P<0.05)。结论重型颅脑损伤患者术后接受持续颅内压监测,能够客观、实时地记录颅内压变化,从而有效地指导临床治疗方案,促进其预后的改善。

Objective To study the value of continuous intracranial pressure monitoring in the postoperative treatment of patients with severe head injury.Methods A retrospective analysis of 60 patients with severe head injury surgery in the department of neurosurgery of Hefei Second People’s Hospital from January 2017 to January 2020 were divided into monitoring group(n=30)and the control group(n=30)according to whether they had performed intracranial pressure probe implantation,the control group judged the changes in intracranial pressure based on the patient’s bone window tension,mental pupils,CT changes,etc.,and decided the treatment plan;the monitoring group was subjected to continuous intracranial pressure monitoring after the operation.Determined the treatment plan based on the objectively recorded intracranial pressure value.According to the Glasgow Coma Index and Glasgow Outcome Score,the prognosis of the two groups of patients was compared and analyzed.Results The prognosis of patients in the monitoring group was better than in the control group,and the difference was statistically significant(χ^(2)=10.689,P<0.05);the GCS scores in the monitoring group were all one week after surgery,two weeks after surgery and at discharge higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Patients with severe head injury undergoing continuous intracranial pressure monitoring after surgery can objectively and real-time record intracranial pressure changes,which can effectively guide clinical treatment plans and promote the improvement of their prognosis.