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目的:探讨颅内压监测在重型颅脑损伤患者临床治疗中的应用价值和意义。方法:将100例重型颅脑损伤患者(GCS评分3～8分)按随机数字表法分为监测组和对照组各50例。监测组患者入院后2 h内或开颅术后置入压力感应器,接压力监测仪行颅内压监测,根据颅内压变化及时行脱水降颅内压治疗:对照组患者未行颅内压监护,仅按常规治疗。比较两组患者的预后及并发症情况。结果:监测组良好16例、轻残14例、重残4例、植物生存6例、死亡10例,对照组良好6例、轻残10例、重残8例、植物生存8例、死亡18例:监测组预后明显优于对照组(P=0.006)。监护组并发症40%(20/50)与对照组60%(30/50)无明显差异(P>0.05)。结论:对重型颅脑损伤患者进行持续颅内压监测,可动态了解颅内压变化,能及时发现颅内继发性病变,指导脱水剂应用,对降低其重残率和病死率,提高治愈率具有重要的临床意义。
Objective: To explore the value and significance of intracranial pressure monitoring in the clinical treatment of patients with severe craniocerebral injury. Methods: One hundred patients with severe traumatic brain injury (GCS score of 3 to 8) were divided into two groups according to random number table: control group and control group. Patients in the monitoring group were placed within 2 hours after admission or after craniotomy. Pressure sensors were placed in the monitoring group, followed by monitoring of intracranial pressure with a pressure monitor. According to the changes of intracranial pressure, dehydration was performed to reduce intracranial pressure. Patients in the control group were treated with intracranial Pressure monitoring, only routine treatment. The prognosis and complications of the two groups were compared. Results: In the monitoring group, there were 16 good cases, 14 mild cases, 4 severe cases, 6 cases of plant survival, 10 cases of death, 6 cases of good control, 10 cases of light disability, 8 cases of severe disability, 8 cases of plant survival and 18 cases of death. Example: The prognosis of the monitoring group was significantly better than that of the control group (P = 0.006). There was no significant difference in 40% (20/50) of the monitoring group and 60% (30/50) of the control group (P> 0.05). Conclusion: Continuous intracranial pressure monitoring in patients with severe craniocerebral injury can dynamically understand the changes of intracranial pressure, which can detect secondary intracranial lesions in time and guide the application of dehydrating agent, which can reduce the severe disability and mortality and improve the cure rate Rate has important clinical significance.