有创颅内压监测对脑外伤去骨瓣减压术患者预后的影响

Effect of intracranial pressure monitoring in postoperative treatment of brain trauma undergoing decompressive craniectomy

目的 分析持续有创颅内压监测指导重型颅脑损伤去骨瓣减压术控制预后不良的意义。方法 选取2018年8月至2020年5月本院行去骨瓣减压术治疗并施加实时颅内压监测的重型颅脑损伤患者50例,根据年龄、性别、入院格拉斯哥评分匹配50例同期未实行有创颅内压监测重型颅脑损伤患者,回顾性分析术后实时颅内压监测与术后6个月预后不良(格拉斯哥预后评分1~3分)的关系。结果 术后实时颅内压监测患者术后6个月预后不良比率为44.0%(22/50),较术后非颅内压监测患者66.0%(33/50)显著下降(P<0.05)。术后实时颅内压监测指导治疗是重型颅脑损伤患者术后6个月预后不良的保护性因素(P<0.05)。结论 术后实时颅内压监测指导治疗可以显著改善重型颅脑损伤患者预后,值得临床推广应用。

Objective To analyze the significance of continuous invasive intracranial pressure monitoring in guiding decompressive craniectomy for severe craniocerebral injury to control poor prognosis.Methods A total of 50 patients with severe craniocerebral injury who underwent decompressive craniectomy and received real-time intracranial pressure monitoring in our hospital from August 2018 to May 2020 were selected.According to age,gender and admission Glasgow score,50 patients with severe craniocerebral injury who did not receive invasive intracranial pressure monitoring during the same period were matched.The relationship between postoperative real-time intracranial pressure monitoring and poor prognosis(Glasgow prognosis score 1-3)at 6 months after operation was retrospectively analyzed.Results Proportion of patients with postoperative 6-month poor prognosis was significantly lower in patients with than without postoperative real-time monitoring of intracranial pressure(22 cases,44.0%vs.33 cases,66.0%,P<0.05).Postoperative real-time monitoring of intracranial pressure for guiding treatment was a protective factor for postoperative 6-month poor prognosis of severe traumatic brain injury patients(P<0.05).Conclusion Postoperative real-time monitoring of intracranial pressure for guiding treatment can obviously improve prognosis of severe traumatic brain injury patients and merits recommendation for clinical application.