重型颅脑损伤后颅内压监护的意义

探讨55例重型脑外伤病人的颅内压(ICP)水平的变化和意义。方法全组病人均经侧脑室额角穿刺进行持续性脑室内压监护并记录，监护时间7小时到5天；监护后2小时的颅内压作为初压(入院压)，分为ICP＜2.67kPa和≥2.67kPa两组。持续监护中将lCP值分为3组＜2.67kPa，2.67～5.33kPa及＞5.33kPa。结果ICP≥2.67kPa者占71％，＞5.33kPa者占16.5％。颅内血肿组ICP较脑挫伤组高(χ

Significance ofIntracranial Pressure Monitoring after Severe Head Injury

To study changes of intracranial pressure (ICP) in 55 patients with severe head injury and their clinical significances. Methods: The frontal horn of lateral ventricle was punctured. The ICP was continuously monitored and recorded.The monitoring duration was 7 hours to 5 days. The ICP at 2 hours after monitoring was acted as an initial value (admission value) . Based on ＜ and ≥2.67 kPa,ICP values were classified into 2 groups. Based on ＜2.67 kPa,2.67～5.33 kPa and ＞5.33 kPa in continuously monitoring, ICP values were divided into 3 groups. Results: ICP was ≥2.67 kPa in 71% of cases,and ＞5.33 kPa in 16.5% .The ICPs in patients with intracranial hematoma were higher than those with brain contusion (x2 = 6.43, P ＜0.05). When an initial value was ≥2.67 kPa, it was associated with a poor outcome (x2 = 7.65, P ＜0.05). There were significant differences between different ICP in continuously monitoring (x2 = 13.23, P ＜0.05).Conclusion:The ICP monitoring may reflect the variations of clinical status and judge prognosis. It can early find secondary brain damages and direct their treatments too.