有创颅内压监测对轻中度颅脑损伤患者治疗方式选择的指导价值

目的:探讨有创颅内压监测对轻中度颅脑损伤患者治疗方式选择的指导价值。方法:回顾分析2011年8月—2013年8月收治的20例轻中度颅脑损伤患者,格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分8~15分,行保守治疗后颅内压呈不可控上升,患者影像学表现、临床体征未出现明确的手术指征,但均有GCS评分降低(均未低于6分)。12例患者的家属选择手术治疗,8例患者的家属选择保守治疗。结果:手术患者与非手术患者远期预后的差异不明显,但手术患者的早期恢复(GCS评分≥13分)优于非手术患者。结论:有创颅内压监测有助于及时了解轻中度颅脑损伤患者的颅内压变化,便于及时调整治疗。

Value of Invasive Intracranial Pressure Monitoring in the Treatment of Mild to Moderate Traumatic Brain Injury

Objective：To explore the clinical significance of invasive intracranial pressure monitoring in the treatment of mild to moderate traumatic brain injury.Methods：The clinical data of 20 patients with mild to moderate traumatic brain injury from Aug 2011 to Aug 2013 were retrospectively analyzed,whose Glasgow coma scale（GCS）was 8-15.After a series of conventional conservative treatment,intracranial pressure uncontrollably increased,However,the patients′imaging,clinical signs did not show clear indications for surgery.GCS dropped in all the 20 cases,but none was lower than6.Among them,12 patients＇ family members chose surgery,while the others chose conservative treatment.Results：Long-term prognosis had no significant difference between the surgery group and the non-surgery group.But the surgery group had more advantages than the non-surgery group in early recovery of consciousness（GCS≥13）.Conclusions：The application of invasive intracranial pressure monitoring can refect the change of intracranial pressure,which is conducive to adjust the treatment in time.