CAJ | 학술논문

目的：探讨动态颅内压（ ICP）监测对重型颅脑损伤（ sTBI）标准大骨瓣减压术治疗的指导意义。方法对62例（监测组） sTBI标准大骨瓣减压患者术后行ICP监测，根据ICP值调整治疗方案，并与同期未行ICP监测的46例（常规组） sTBI标准大骨瓣减压患者的疗效、并发症及甘露醇应用的时间和计量作比较。结果监测组脱水剂应用时间及剂量较未监测组低，监测组急性肾功能损伤和电解质紊乱发生率较未监测组低，而肺部感染、尿路感染和上消化道出血等三种并发症方面差异无统计学意义；监测组预后优于常规组。结论动态ICP监测能较好地反应sTBI标准大骨瓣减压术后ICP的变化，通过个体化治疗能有效控制ICP，维持脑灌注压，减少并发症，降低sTBI的致残率和病死率。
목적：탐토동태로내압（ ICP）감측대중형로뇌손상（ sTBI）표준대골판감압술치료적지도의의。방법대62례（감측조） sTBI표준대골판감압환자술후행ICP감측，근거ICP치조정치료방안，병여동기미행ICP감측적46례（상규조） sTBI표준대골판감압환자적료효、병발증급감로순응용적시간화계량작비교。결과감측조탈수제응용시간급제량교미감측조저，감측조급성신공능손상화전해질문란발생솔교미감측조저，이폐부감염、뇨로감염화상소화도출혈등삼충병발증방면차이무통계학의의；감측조예후우우상규조。결론동태ICP감측능교호지반응sTBI표준대골판감압술후ICP적변화，통과개체화치료능유효공제ICP，유지뇌관주압，감소병발증，강저sTBI적치잔솔화병사솔。
Objective To investigate the significance of intracranial pressure (ICP) monitoring in severe traumatic brain injury ( sTBI ) patients after standard large trauma craniectomy .Methods 62 patients ( monitoring group ) who underwent ICP monitoring were treated according to the ICP values after standard large trauma craniectomy ,and 46 patients ( control group ) without ICP monitoring were treated according to experience .Then,the comparison of the time and dose of mannitol application , complications and prognosis in the two groups were performed .Results The time and dose of mannitol application in the monitoring group was less than the control group .And the rate of acute kidney injury and electrolyte disorder in the monitoring group was less than that in control group , but there was no significant difference in the rate of pulmonary infection , urinary tract infection and hemorrhage of upper digestive tract between the two groups .The prognosis in the monitoring group was better than the control group .Conclusions Dynamic changes of ICP after decompressive craniectomy in patients with severe traumatic brain injury could be showed in the ICP monitor .We can effectively control ICP ,maintain cerebral perfusion pressure , reduce complications , morbidity and mortality by individualized treatment .