有创颅内压监测在颅脑创伤救治中的应用

目的 探讨有创颅内压监测在颅脑创伤救治中的作用.方法 2003年7月-2007年12月使用有创颅内压监测治疗116例颅脑创伤患者(重型112例,中型3例,轻型1例),全部患者均在入院后24 h内行颅内压监测,并依据监测结果控制颅内压,包括药物降颅内压和手术治疗.结果 本组患者生存74例,42例重型患者死亡.GCS 3～5分组共75例,死亡33例,病死率为44%;GCS 6～8分组37例,死亡9例,病死率24%;GCS 9～15分组4例,无死亡.结论 持续有创颅内压监测可及时了解颅内压变化,有利于早期诊断及指导治疗,并对判断预后有着十分重要的意义,GCS评分低、颅内压高的患者预后差.

Application of invasive intracranial pressure monitoring in treatment of traumatic brain injury

Objective To discuss the effect of invasive intracranial pressure (ICP) monitoring in treating traumatic brain injury (TBI).Methods A total of 116 patients with TBI (including 112 with severe TBI,3 with moderate TBI and 1 with slight TBI) were monitored by using invasive ICP monitoring device in Tiantan Hospital from July 2003 to December 2007.All patients underwent ICP monitoring within first 24 hours after admission and treated with corresponding therapy including drug therapy and surgical treatment.Results Of all,74 patients survived but 42 with severe TBI died.Of 75 patients with GCS 3-5,33 died,with morbidity rate of 44%.Of 37 patieats with GCS 6-8,nine died,with morbidity rate of 24%.Four patients with GCS 9-15 survived.Conclusions Continuous ICP monitoring can help timely understanding of ICP changes for early diagnosis and correct treatment of TBI and is useful for judgment of prognosis.Low GCS and high ICP are predictors for bad outcome.