颅内压监测在闭合性重型颅脑损伤患者中的应用  

Application of intracranial pressure monitoring in patients with closed severe traumatic brain injury

作　　者：谯飞[1,2] 范润金[1,2] 张逵[1,2] 尚彬[1,2] 刘毅[1,2] 唐辉[1,2] 任海波[1,2] 邓学云[1,2] 

机构地区：[1]川北医学院第二临床医学院 [2]南充市中心医院神经外科,四川南充637000

出　　处：《西部医学》2015年第6期888-890,共3页Medical Journal of West China

摘　　要：目的 探讨通过颅内压（ICP）监测有针对性地控制颅内压,进而达到改善闭合性重型颅脑损伤（sTBI）患者预后的价值.方法 回顾分析我院2012年7月～2013年12月收治的75例闭合性重型颅脑损伤患者的临床资料,按是否行颅内压监测,分为ICP组36例和非ICP组39例,比较两组的病死率、NICU监护时间和GOS预后评分.结果 ICP组患者的病死率为19.4％,非ICP组患者为35.9％,前者病死率明显低于后者（P＜0.01）;两组患者在NICU监护时间比较,ICP组为（15.38＆#177;7.29）天,非ICP组为（26.34士15.63）天,组间差异有显著性（P＜0.01）;3个月时随访患者的GOS评分,ICP组[（4.17＆#177;1.16）分]优于非ICP组[（3.69＆#177;1.56）分,P＜0.05].结论 颅内压监测可指导控制sTBI患者的颅内压,减少高颅压的继发脑损伤,提高脑灌注压,降低sTBI患者的死亡率,改善其预后.Objective To research the effect of intracranial pressure monitoring in patients with closed severe trau- matic brain injury （sTBD. Methods We retrospectively analyzed 75 severe brain injury patients. According to whether using intracranial pressure monitoring, we divided the patients into ICP group and non-ICP group. There were 36 cases in ICP group and 39 cases in non-ICP group. The mortality, care time in NICU and GOS prognostic score were compared between the two groups. Results The mortality of ICP group was 19.4%o, while 35.9% in the non-ICP group. The former was signi{icantly lower than the latter（P〈0.01）. The care time in NICU were （15.38±7.29） days and （26.34± 15.63） days respectively （P〈0.01）. We follow-up the patients with GOS score at 3 months,the scores were （4.17± 1.16） points and （3.69±1.56） points respectively （P〈0.05）, the patients of ICP groups achieved better results. Conclusions Intracranial pressure monitoring can direct doctors to control the intracranial pressure of sTBI patients, reducing the secondary brain injury of high intracranial pressure and to improve the cerebral perfusion pressure. It will be helpful to reduce the mortality rate and to improve the prognosis of these patients.

关 键 词：闭合性重型颅脑损伤 颅内压监测 预后 

分 类 号：K651.15[历史地理—历史学]