持续性颅内压监测应用于急性重型颅脑外伤治疗的意义

发布时间：2018-01-31 07:52

本文关键词： 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　出处：《中国现代医学杂志》2017年11期 　论文类型：期刊论文

【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(P0.05),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(P0.05),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。
[Abstract]:Objective to explore the significance of continuous intracranial pressure monitoring in the treatment of acute severe craniocerebral trauma. Methods 300 patients with acute severe craniocerebral trauma admitted to our hospital from January 2013 to January 2016 were selected. Patients in the monitoring group were divided into monitoring group and control group by random digital table method. The patients in the control group were treated with routine therapy and the patients in the monitoring group were monitored with invasive and sustained intracranial pressure within 2 days after admission. The patients in the control group and the monitoring group were treated with different monitoring and treatment measures for 30 days, and Glasgow prognosis score (GOS) was performed. The neurological function score (NIHSS), activity of daily living (ADL), complications and mortality were evaluated. Results compared with the control group, the patients in the monitoring group were compared with the control group. The GOS Glasgow score and ADL score in the monitoring group were higher than those in the control group. The neurological function score of the monitoring group was lower than that of the control group. The electrolyte disturbance, acute renal damage, gastrointestinal bleeding, urinary tract infection, pulmonary infection, intracranial infection in the monitoring group. The incidence and mortality of hematoma were significantly different from those of the control group (P 0.05). The electrolyte disturbance, acute renal damage, gastrointestinal hemorrhage and urinary tract infection were observed in the monitoring group. The incidence of pulmonary infection and mortality were lower than that of the control group, and the incidence of intracranial infection and hematoma was higher than that of the control group. Conclusion continuous intracranial pressure monitoring can restore the normal life of patients with acute severe craniocerebral trauma. To protect their activities of daily life, to reduce the degree of nerve damage, and to reduce complications and mortality play a role.
【作者单位】：苏州大学附属第二医院神经外科;
【分类号】：R651.15
【正文快照】： 重型颅脑外伤属于多发病、常见病,是青壮年人群致残致死的主要原因之一[1]。重型颅脑外伤后会导致继发性颅内压增高,从而引起一系列病生理改变,如脑水肿、脑组织缺血缺氧及脑组织灌注不足等,进一步导致颅内高压加重,形成恶性循环[2]。近年来逐步开始应用的持续性颅内压监测可

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