有创颅内压监测和阶梯式方案治疗进展性脑挫裂伤  

Invasive intracranial pressure monitoring and stepwise management of progressive cerebral contusion

作　　者：刘科峰[1] 吴智远[1] 龚坚[1] 文世宏 王有刚[1] 

机构地区：[1]南京医科大学附属常州第二人民医院神经外科,常州213001

出　　处：《临床神经外科杂志》2014年第5期363-366,共4页Journal of Clinical Neurosurgery

摘　　要：目的探讨有创颅内压监测进展性脑挫裂伤颅内压变化,及采用阶梯式治疗方案控制颅高压的治疗效果。方法硬膜下或脑室内探头置入颅内,并持续监测颅内压,运用阶梯式治疗方案降低颅内压。结果 21例患者均成功置入颅内压监测探头。9例患者随即转开颅手术;12例采用保守治疗,其中8例在保守治疗过程中ICP持续上升转开颅手术。GOS评分5分13例,4分8例。结论有创颅内压监测能客观、准确和及时反应颅内压变化。阶梯式治疗方案有效降低颅内压,改善预后。Objective To discuss invasive intracranial pressure monitoring for progressive cerebral contusion patients , and effectiveness of stepwise management of elevated Intracranial pressure .Methods A subdural or ventriculostomy catheter was implanted and intracranial pressure was measured continuously .The stepwise management was adopted to reduce intracranial pressure . Results 21 patients were successfully implanted intracranial pressure monitoring catheter .In 9 patients underwent craniotomy peration immediately .12 patients received conservative treatment , 8 cases in thouse cases as ICP increased continuously have to craniotomy operation .According to GOS for assessment of outcome , 5 point in 13 cases, and 4 point in 8 cases.Conclusions Invasive intracranial pressure monitoring can objectively , accurately and timely response to changes of intracranial pressure .The stepwise management effectively reduces intracranial pressure , improving the prognosis .

关 键 词：颅脑外伤 脑挫裂伤 颅内压 监测 预后 

分 类 号：R651.1[医药卫生—外科学]