颅内压监护在急性重型颅脑损伤患者中的应用价值

摘要

目的 探讨颅内压监护(IPM)在急性重型颅脑损伤(ASCI)患者中的应用价值.方法 选取2015年6月～2016年10月复旦大学附属中山医院青浦分院神经外科治疗的96例ASCI患者,并按照随机数字表法分为研究组和对照组,每组各48例.对照组予以临床常规治疗,研究组则在对照组常规治疗的基础上予以IPM,根据患者监护结果予以针对性治疗.进行随访6个月,比较两组预后情况,甘露醇使用时间、甘露醇使用剂量以及住院时间,术后并发症发生情况.结果 研究组预后情况优于对照组,差异有统计学意义(P＜0.05);研究组甘露醇使用时间、住院时间均明显短于对照组(P＜0.05),甘露醇使用剂量明显少于对照组(P＜0.05);研究组上消化道出血、电解质紊乱、肾功能损害发生率均分别明显低于对照组,差异有统计学意义(P＜0.05).结论 将IPM应用于ASCI患者的治疗可获得良好效果,此举可有效减少甘露醇使用时间以及使用剂量,同时缩短患者的住院时间,降低术后并发症的发生,存在较好的安全性,值得推广.%Objective To explore the application value of intracranial pressure monitoring (IPM) in patients with acute severe craniocerebral injury (ASCI).Methods From June 2015 to October 2016,96 patients with ASCI admitted to Department of Neurosurgery of Qingpu Branch Hospital of Zhongshan Hospital Affiliated to Fudan University were selected,and divided into study group and control group by random number table,with 48cases in each group.The control group was given routine clinical treatment,the study group was given IPM on the basis of routine treatment in the control group,and targeted treatment according to the patient's monitoring results.Follow-up was conducted for 6 months,the conditions of prognosis,use time of mannitol,dosage of mannitol and hospital stay,postoperative complications between two groups were compared.Results The conditions of prognosis in the study group was better than control group,the difference was statistically significant (P ＜ 0.05).The use time of mannitol and hospital stay in the study group were shorter than those of control group (P ＜ 0.05),the dosage of mannitol was lower than control group (P ＜ 0.05).The upper digestive tract hemorrhage,electrolyte disorders and renal damage rate in the study group were lower than those of control group,the difference were statistically significant (P ＜ 0.05).Conclusion IPM should be effective in the treatment of patients with ASCI,which can effectively reduce the use time and dosage of mannitol,shorten the length of hospital stay and reduce the incidence of postoperative complications.The safety is better,and it is worthy of clinical application.