颅内压监测与常规监测在重症颅脑外伤中的应用价值比较

摘要

Objective To retrospectively analyze the significance of dynamic intracranial pressure monitoring and routine monitoring in the treatment of severe traumatic brain injury.Methods Forty-two patients with severe craniocerebral trauma who were admitted into our hospital from March 2013 to December 2015 and underwent intracranial pressure monitoring were enrolled in this study as the observation group.Thirty-nine patients with severe traumatic brain injury who were routinely monitored within 3 hours after admission were selected as the control group in the corresponding period.Timely take drugs or surgical treatment according to the monitoring results,and analyzed the clinical efficacy,craniotomy cases,time of admission to craniotomy,and complications of the two groups.Results The cases with good prognosis in the control group was 24 (61.5％) while it was 31 (73.8％) in the observation group,and the difference was statistically significant (P ＜ 0.05).The cases with poor prognosis in the control group was 15 (38.5％) while it was 11 (26.2％) in the observation group,and the difference was statistically significant(P ＜0.05).Therer were 13 cases (30.1％) of craniotomy in the control group and 5 cases (12.8％) in the observation group with statistically significant difference (P ＜ 0.05).The time of admission to craniotomy in the control group was (24.5 ± 1.7) hours,and it was (18.3 ± 2.4) house in the observation group with statistically significant difference (P ＜ 0.05).The incidence of intracranial infection complication was 9.5％ in the control group and 8％ in the observation group.There was no significant difference between the two groups (P ＞ 0.05).Conclusion Invasive intracranial pressure monitoring can reflect the changes of patients in time,which can improve the clinical curative effect and would not increase the incidence of intracranial infection.%目的 分析比较动态颅内压监测与常规监测对重型颅脑外伤患者救治的意义.方法 回顾性分析我院2013年3月至2015年12月收治的42例入院后3h内行有创动态颅内压监测的重症颅脑外伤患者的临床资料,并将其作为观察组,同期选择39例入院后3h内行常规监测的重症颅脑外伤患者作为对照组,依据监测结果控制颅内压,适时采取药物或手术治疗.分析比较2组患者的临床疗效、开颅治疗例数、入院至开颅时间及并发症情况.结果 对照组预后良好24例(61.5％),观察组预后良好31例(73.8％),2组比较差异具有统计学意义(P＜0.05);对照组预后不良为15例(38.5％),观察组为11例(26.2％),2组比较差异具有统计学意义(P＜0.05).对照组开颅13例(30.1％),观察组为5例(12.8％),2组比较差异具有统计学意义(P＜0.05);对照组入院至开颅时间为(24.5±1.7)h,观察组为(18.3±2.4)h,差异具有统计学意义(P＜0.05).对照组并发症发生率为9.5％,观察组为8％,2组比较差异无统计学意义(P＞0.05).结论 有创颅内压监测与常规检测相比,能更及时反映患者病情变化,有助于提高患者临床疗效,且并不增加颅内感染并发症的发生率.