持续性颅内压监测应用于急性重型颅脑外伤治疗的意义  

Effect of continuously intracranial pressure monitor in patients with acute heavy craniocerebral injury

作　　者：袁利群[1] 陈延明[1] 刘士海[1] 

机构地区：[1]苏州大学附属第二医院神经外科,江苏苏州215004

出　　处：《中国现代医学杂志》2017年第11期103-107,共5页China Journal of Modern Medicine

摘　　要：目的探讨持续性颅内压监测应用于急性重型颅脑外伤治疗的意义。方法选取2013年1月-2016年1月收入该院的急性重型颅脑外伤患者300例,采用随机数字表法将入选病例分为监测组和对照组,对照组行常规治疗,监测组患者入院2 d内行有创持续颅内压监测,并根据监测结果给予相应治疗措施。在对照组及监测组患者分别接受不同监护及治疗措施30 d后为时间点,进行格拉斯哥预后评分(GOS)、神经功能评分(NIHSS)、日常生活活动能力评分(ADL)及并发症及死亡率评定。结果监测组的GOS、ADL及NIHSS与对照组相比,差异有统计学意义(P<0.05),监测组的GOS格拉斯哥评分及日常生活活动能力评分较对照组高,监测组的神经功能评分较对照组低。监测组的电解质紊乱、急性肾损害、消化道出血、尿路感染、肺部感染、颅内感染、血肿发生率及死亡率与对照组相比差异有统计学意义(P<0.05),监测组的电解质紊乱、急性肾损害、消化道出血、尿路感染、肺部感染发生率及死亡率均较对照组低,颅内感染及血肿发生率较对照组高。结论持续性颅内压监测对于急性重型颅脑外伤患者恢复其正常生活、保护其日常生活活动能力、降低神经受损程度以及降低并发症和死亡率起到一定的作用。Objective To study the effect of continuously intracranial pressure monitoring on acute heavy craniocerebral injury case. Methods 300 cases with acute heavy craniocerebral injury were recieved from January 2013 to January 2016. According to random number table, all cases were devided into monitor group and control group. The control group had conventional treatment. The monitor group started with continuously intracranial pressure monitoring in two days after hospitalized, and the therapeutic measures were result in the consequence of monitoring. After 30 days, the GOS, NIHSS, ADL of the cases were checked. Results The GOS, NIHSS and ADL between two groups had significant difference （P〈 0.05）. The GOS and evaluation on activities of daily living of the monitoring group were higher than the control group, and its neurological scoring was lower. In the monitoring group, the morbidity of electrolyte disturbance, acute kidney injury, digestive tract-hemorrhage, urinary tract infection, pulmonary infection, and mortality were significant lower than those in the control group. In the monitoring group, the intracranial infection and hematomas were significant higher than those in the control group. Conclusions Continuously intracranial pressure monitoring is effective in curing acute heavy craniocerebral injury cases. It helps patients rebuild normal lives, protects their activities of daily living, reduces harm, complications and mortality.

关 键 词：颅内压监测 重型颅脑外伤 格拉斯哥预后评分 日常生活活动能力评分 神经功能评分 

分 类 号：R651[医药卫生—外科学]