颅脑损伤术后颅内压监测的临床作用及意义  

The clinical effect and value of intracranial pressure(ICP) monitoring in patients after traumatic brain injury surgery

作　　者：樊宇耕 杨海贵[1] 张维涛[1] 杜宏瑞[1] 张永兵[1] 高永开 白小飞[1] 王亚飞[1] 寇欣[1] 李郭辉 

机构地区：[1]延安市人民医院神经外科,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2015年第4期27-29,32,共4页Journal of Yan'an University:Medical Science Edition

基　　金：延安市科学技术研究发展计划项目(项目号:2012kw-04)

摘　　要：目的探讨颅内压(ICP)监测在颅脑损伤术后患者临床治疗中的作用及意义。方法回顾性分析108例在我科因颅脑损伤收住院手术治疗的患者,根据患者术后是否行ICP进行分组。其中62例行ICP监测作为监测组,参考ICP监测数据值作为调整治疗方案。常规组中46例根据患者意识、生命体征等临床症状变化情况采取相应的治疗措施。对比两组患者的疗效(GOS评分)、甘露醇的应用情况、术后并发症等差异。结果监测组患者预后有效率为69.35%(43/62),明显优于常规组(P<0.05)。监测组术后并发症发生率为12.90%(8/62),明显低于常规组(P<0.05)。监测组甘露醇使用剂量均值为(758.5±35.9)g,使用时间为(6.4±2.5)d,均明显低于常规组(P<0.05)。结论颅内压监测在急性重型颅脑损伤中的临床应用价值确切,对颅脑损伤术后患者应及早动态观察颅内压力变化,有助于指导临床脱水药物的使用,降低术后并发症,合理有效的治疗措施可提高患者术后生存率,减少病残率,并对患者临床预后具有较好的评估价值。Objective To explore the clinical application value of intracranial pressure（ ICP） monitoring in patients after acute severe traumatic brain injury（ s TBI surgery（ s TBI）. Methods 106 patients were analyzed for acute severe traumatic brain injury. 62 cases as experiment group were carried out routine ICP monitoring according to ICP monitoring data values,and adjusted the treatment plan as the values. The treatments of 46 cases in control group were taken corresponding measures according to patients＇ consciousness,vital signs and clinical symptoms. The curative effect（ GOS score）,the application of mannitol and the differences of complications were contrasted of two groups. Results The prognosis of experiment group effective rate was 69. 35%（ 43 /62）,significantly better than the control group（ P〈0. 05）. The complication rate of experiment group was 12. 90%（ 8 /62）,significantly lower than the control group（ P〈0. 05）. The mean dose of mannitol in the experiment group was（ 758. 5 ± 35. 9） g,and the drug administration time was（ 6. 4 ± 2. 5） d,the two of which was significantly lower than that of the con trol group（ P〈0. 05）. Conclusion Intracranial pressure monitoring in the clinical application of acute severe craniocerebral injury is clear. Early dynamic observation of intracranial pressure changes of postoperative patients with craniocerebral injury help guide clinical use of dehydration drugs and reduce the postoperative complications. Reasonable and effective treatment can improve the postoperative survival rate,reduce the sick rate,and the clinical prognosis is of great value assessment.

关 键 词：急性重型颅脑损伤 颅内压监测 术后 并发症 

分 类 号：R651.15[医药卫生—外科学]