脑室置管颅内压监护在重型颅脑损伤术后的临床应用

目的探讨重型颅脑损伤患者术后持续颅内压监护的临床价值。方法选择90例重型颅脑损伤开颅手术患者,术前随机分为颅内压(ICP)监护组(45例)和常规治疗组(45例),ICP监护组根据颅内压的变化随时调整治疗方案,常规治疗组根据经验进行常规神经外科治疗。结果 ICP监护组术后甘露醇应用时间、剂量及电解质紊乱、急性肾功能损害并发症的发生率均低于常规治疗组,差异有统计学意义(P<0.05),而应激性溃疡和颅内感染并发症发生率比较,差异无统计学意义(P>0.05)。术后ICP初值对预后评估有指导作用。结论重型颅脑损伤患者术后持续ICP监护有利于及时调整治疗措施,对降低并发症、改善和评估预后有重要意义。

Clinical Value of Post-Operative Intracranial Pressure Monitoring Via Intraventricular Catheter in Patients with Severe Traumatic Brain Injury

Objective To investigate the value of post-operative continuous intracranial pressure(ICP) monitoring in patients with severe traumatic brain injury(TBI).Methods Ninety patients with severe traumatic brain injury treated with craniotomy were randomly divided into ICP monitoring group(n=45) and routine treatment group(n=45).In ICP monitoring group,the treatment methods were adjusted according to the changes of ICP,whereas the patients in routine treatment group underwent general treatment according to standard neurosurgical protocol.Results There was statistical difference in aspects of time duration and mannitol dosage between two groups(P<0.05).The occurrence of electrolyte disturbance and acute renal failure between two groups showed significant statistical difference(P<0.05),while the occurrence of stress ulcer and intracranial infection were beyond of statistical difference between two groups(P>0.05).The post-operative initial ICP level played a directive role in estimating the prognosis.Conclusion Continuous ICP monitoring in post-operative patients with severe traumatic brain injury is valuable in adjusting the therapy,reducing the complications and in improving the prognosis.