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目的:观察有创颅内压监测(ICP)对重型脑外伤手术患者的预后影响。方法:102例重型脑外伤手术患者随机分为ICP组和非ICP组。脑外伤术后,两组分别根据ICP值和临床症状及CT结果行阶梯式降颅压治疗。比较两组的ICU住院时间、总住院时间、住院费用、甘露醇用量、并发症发生率及6个月死亡率、GOSE评分、预后不良率。结果:两组的总住院时间、总体死亡率、GOSE评分及预后不良率无明显差异。与非ICP组相比,ICP组的ICU住院时间长,住院费用高,甘露醇用量少,电解质紊乱发生率低。根据术前GCS评分将患者分为低分组(GCS3-5分)和高分组(GCS6-8分)。低分组行ICP监测可显著提高GOSE评分,降低预后不良率。高分组预后无明显差异。结论:ICP监测可显著减少甘露醇用量,降低电解质紊乱发生率,改善重型脑外伤低分组的预后。
Objective: To observe the prognostic significance of invasive intracranial pressure monitoring (ICP) in patients with severe traumatic brain injury. Methods: 102 patients with severe traumatic brain injury were randomly divided into ICP group and non-ICP group. After traumatic brain injury, two groups were treated with step-down intracranial pressure according to ICP value and clinical symptoms and CT results respectively. ICU length of stay, total length of stay, cost of hospitalization, mannitol consumption, complication rate, 6-month mortality, GOSE score, and prognosis were compared between the two groups. Results: There was no significant difference between the two groups in total hospital stay, overall mortality, GOSE score and prognosis. Compared with the non-ICP group, ICP group ICU long hospitalization, hospitalization costs, less mannitol, electrolyte imbalance in the incidence of low. According to the preoperative GCS score, patients were divided into low group (GCS3-5) and high group (GCS6-8). Low-sub line ICP monitoring can significantly improve the GOSE score, reduce the rate of poor prognosis. High score group no significant difference in prognosis. Conclusion: ICP monitoring can significantly reduce the amount of mannitol, reduce the incidence of electrolyte imbalance and improve the prognosis of severe traumatic brain injury group.