茚甲新治疗顽固性颅内高压的效果观察

目的探讨茚甲新治疗重型颅脑创伤后顽固性颅内高压的临床效果及可行性。方法选择36例重型颅脑创伤后出现顽固性颅内高压的患者，应用茚甲新治疗，比较治疗前后ICP、CCP以及大脑中动脉平均血流速率（VmMCA）的变化，并对患者进行随访评估预后。结果用药30、60、120min后的ICP水平低于用药前，CCP、VmMCA水平均高于用药前，差异均有统计学意义（P〈0．05），且持续静脉点滴期间平均ICP和CCP水平较之首剂量后变化不明显，6例患者应用茚甲新后ICP和CCP变化不明显，随访6个月生存率为为61．1％，预后良好率为27．8％。结论茚甲新对于顽固性颅内高压患者，可显著降低其ICP、增高CCP，对于改善此类患者的预后有积极的作用。

Clinical effect of indomethacin treating refractory intracranial hypertension after severe craniocerebral trauma

Objective To discuss the clinical effect and feasibility of indomethacin treating refractory intracranial hypertension after severe craniocerebral trauma. Methods 36 patients with refractory intracranial hypertension after severe craniocerebral trauma were treated with indomethacin.The ICP,CCP and the Mean velocity？of middle cerebral artery （VmMCA） were compared before and after treatment and the follow-up evaluation of prognosis for patients were carried on. Results The level of ICP after 30,60,120 min were lower than before drug-using and the lever of CCP and VmMCA were higher than before drug-using （P〈0.05）.The change was not significantly about the ICP and CCP during the continuous intravenous drip than the first dose.The effect of indomethacin was not significantly about the ICP and CCP in 6 patients. The survival rate was 61.1% and the better prognosis was 27.8% after 6 months. Conclusion The indomethacin can significantly reduce the ICP, increase the CCP and has a positive effect to the patients with intracranial hypertension under severe traumatic brain injury.