脑室型颅内压监测在特重型颅脑损伤中的临床应用  

Clinical application of ventricular intracranial pressure monitoring in severe craniocerebral trauma

作　　者：黄齐兵[1] 张源[1] 宋承明 苏雨行[1] 张泽立[1] 王广辉[1] 

机构地区：[1]山东大学齐鲁医院急诊外科,济南250012 [2]山东省齐河县人民医院神经外科

出　　处：《中华创伤杂志》2013年第2期107-110,共4页Chinese Journal of Trauma

摘　　要：目的探讨脑室型颅内压监测对特重型颅脑损伤后颅内压增高治疗的临床应用价值。方法回顾性分析2010年10月-2012年1月收治40例特重型颅脑损伤患者，GCS3～5分，均行双侧去骨瓣减压术。将40例患者按入院先后随机分为三组，即A组：12例先置入脑室型颅内压探头再开颅手术；B组：15例先开颅手术再置入脑室型颅内压探头；对照组：13例行单纯性颅内压监测探头置人术。比较各组颅内压控制、脱水剂使用时间、剂量及预后。结果A、B组控制颅内压〈15mmHg明显优于对照组，甘露醇的剂量及时间明显减少，预后较好（P〈0．05）；A组重残及植物生存7例，B组3例（P〈0．05）。结论应用脑室型颅内压监测，可有效控制颅内压，提高特重型颅脑损伤的救治成功率，减少甘露醇的使用剂量。Objective To investigate the clinical value of ventricular intracranial pressure monitoring in treatment of severe eraniocerebral trauma with high intraeranial pressure. Methods A retrospective analysis was conducted on forty cases of severe cranioeerebral trauma with GCS score of 3-5 undergone bilateral deeompressive cranieetomy from October 2010 to January 2012. The patients were divided into three groups： Group A （12 cases received eraniotomy after the placement of ventricular intraeranial pressure probe） ; Group B （15 cases had craniotomy ahead of the probe placement） ; control group （13 cases had probe placement alone）. Intraeranial pressure control, dose and duration of administration of dehydrator and prognosis were compared among groups. Results Groups A and B showed a better result in aspects of controlling intraeranial pressure within 15 mm Hg, close and duration of mannitol treatment, and prognosis, as compared with control group （ P 〈 0.05 ）. Furthermore, Group A had seven cases of severe disability or in vegetable state, but only three cases in Group B （ P 〈 0.05 ）. Conclusion Ventricular intracranial pressure monitoring can effectively reduce intracranial pressure, raise treatment success rate and decline the use of mannitol in management of severe eraniocerebral trauma.

关 键 词：颅脑损伤 颅内压 预后 

分 类 号：R651.15[医药卫生—外科学]