颅内压监测在严重脑外伤治疗中的临床应用价值  

Clinical value of intracranial pressure monitoring in the treatment of severe traumatic brain injury

作　　者：王剑[1] 卿国忠[1] 王力[1] 凌洪[1] 

机构地区：[1]南华大学附属第一医院急诊外科,湖南衡阳421001

出　　处：《中国现代医生》2017年第17期21-23,共3页China Modern Doctor

基　　金：湖南省教育厅科研项目(17C1390)

摘　　要：目的评价应用颅内压监测在严重脑外伤治疗中的应用价值。方法回顾性分析2013年1月~2016年3月于我院就诊的132例严重脑外伤患者,根据是否进行颅内压监测,分为观察组(34例)和对照组(98例),比较两组患者的12个月内总死亡率、院内死亡率、机械通气时间、ICU留住时间、总住院时间、术后当日(T1)格拉斯哥昏迷评分(GCS)、术后6个月和12个月格拉斯哥预后量表评分(GOS)。结果观察组的总死亡率和院内死亡率分别为52.94%和20.59%,显著低于对照组的71.43%和43.88%(P<0.05);观察组的机械通气时间、ICU留住时间和总住院时间明显短于对照组(P<0.05),两组间术后GCS评分、6个月和12个月GOS评分存在明显差异(P<0.05)。结论在严重脑外伤治疗中应用颅内压监测技术,有助于及时、有效地给予相关治疗,可以显著改善患者的预后,值得推广。Objective To evaluate the application value of intracranial pressure monitoring in the treatment of severe traumatic brain injury. Methods A total of 132 cases of severe traumatic brain injury in our hospital from January 2013 to March 2016 were retrospectively analyzed. The patients were divided into observation group （n=34） and control group （n=98） according to whether to undergo intracranial pressure monitoring. The total mortality and in-hospital mortality, mechanical ventilation time, ICU retention time and total length of hospital stay, the Glasgow Coma Score （GCS） on the day after surgery, the Glasgow prognosis scale （GOS） at 6 months and 12 months after surgery were compared between the two groups. Results The total mortality and in-hospital mortality were 52.94% and 20.59% in the observation group, which were significantly lower than those in the control group（71.43% and 43.88%, respectively）（P〈0.05）. The mechanical ventilation time, ICU retention time and the total length of hospital stay in the observation group were significantly shorter than those in the control group（P〈0.05）. There were significant differences in postoperative GCS scores and the Glasgow prognosis scale（GOS） at 6 months and 12 months between the two groups（P〈0.05）. Conclusion The application of intracranial pressure monitoring technique in the treatment of severe traumatic brain injury can significantly help to improve the prognosis of patients with timely and effective treatment, which is worthy to be popularized.

关 键 词：脑外伤 颅内压 死亡率 开颅术 预后 

分 类 号：R651.15[医药卫生—外科学]