早期脑室置管行颅内压监护对中型颅脑损伤患者的预后影响

目的　探讨早期脑室置管行颅内压 (ICP)和脑灌注压 (CPP)监护在中型颅脑损伤中的临床应用价值。方法　将 12 5例伤后 2 4h入院无手术指征的中型颅脑损伤 (GCS 9～ 12分 )患者 ,随机分为ICP监护组 :入院后即经恻脑室内穿刺置管行ICP与CPP连续监测 ,根据颅内压变化调整治疗方案 ;对照组 :入院后不做ICP监测 ,依据临床观察的意识及生命体征变化 ,进行治疗。结果　颅内压监护组脱水剂剂量、应用时间均低于对照组 ,疗效优于对照组 ,两组差异有显著意义 (P <0 0 5 )。结论　中型颅脑损伤病情极不稳定 ,早期行ICP监护能及早发现病情变化 ,对及时采取有效治疗措施 ,降低死残率 ,改善预后有重要意义。

The Effect of Intracranial Pressure Monitoring via Early Intubation into Ventricle on the Prognosis of Moderate Traumatic Brain Injury

Objective To discuss the clinically applicative value of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring via early intubation into brain ventricle in moderate traumatic brain injury.Methods 125 patients of moderate traumatic brain injury without operative indication, admitted to hospital in 24 hours after trauma, were divided into ICP and control group at random. Patients of ICP group were given successive ICP and CPP monitoring via early intubation into the ventricle, and their therapeutic schemes were adjusted on the basis of ICP fluctuation. As for control group, its therapy, not including ICP monitoring, was administered according to clinical observation on the conditions of consciousness and vital signs.Results The therapeutic effect of ICP group, with lower dosage of dehydrant and shorter administering period, was better than that of control group. There was significant difference between them (P<0.05). Conclusion It is showed that early ICP monitoring be beneficial to lowing the mortality and improving the prognosis of moderate traumatic brain injury for its status in indicating the unstable disorder and in adjusting the therapy.