CAJ | 학술논문

目的探讨颅内压监测在重型颅脑损伤治疗中的临床应用和预后之间的关系.方法回顾性研究2008年6月至2012年2月在山东大学齐鲁医院收治的216例手术干预的重型颅脑损伤患者(格拉斯哥评分3～8分),其中未应用颅内压监测探头患者为对照组,48例;应用颅内压监测的患者为研究组,168例.再将研究组分为3组A、B、C3组,根据颅内压变化予以相应的阶梯式治疗,以达到理想的颅内压控制及维持脑灌注压,分析颅内压与预后的关系.结果与对照组相比,研究组致残率及死亡率明显降低,预后改善,尤其是先行开颅手术再行脑室型颅内压监测探头置入术组患者预后较好;研究组应用甘露醇的剂量及时间较对照组明显降低(P＜0.05),术后颅内压控制良好者预后较好.结论重型颅脑损伤患者应用颅内压监测指导治疗,提高救治成功率、降低死亡率、改善预后.
목적 탐토로내압감측재중형로뇌손상치료중적림상응용화예후지간적관계.방법 회고성연구2008년6월지2012년2월재산동대학제로의원수치적216례수술간예적중형로뇌손상환자(격랍사가평분3～8분),기중미응용로내압감측탐두환자위대조조,48례;응용로내압감측적환자위연구조,168례.재장연구조분위3조A、B、C3조,근거로내압변화여이상응적계제식치료,이체도이상적로내압공제급유지뇌관주압,분석로내압여예후적관계.결과 여대조조상비,연구조치잔솔급사망솔명현강저,예후개선,우기시선행개로수술재행뇌실형로내압감측탐두치입술조환자예후교호;연구조응용감로순적제량급시간교대조조명현강저(P＜0.05),술후로내압공제량호자예후교호.결론 중형로뇌손상환자응용로내압감측지도치료,제고구치성공솔、강저사망솔、개선예후.
Objective To explore the clinical application of intracranial pressure (ICP) monitoring and its prognostic correlation in patients with severe craniocerebral injury.Methods A total of 216 severe craniocerebral injury patients with scores of Glasgow coma scale 3-8 underwent craniotomy at Affiliated Qilu Hospital,Shandong University.And 168 cases of ICP monitoring were divided into 3 treatment groups and another 48 cases without ICP monitoring selected as the control group.According to ICP,stepwise treatment was administered to control the level of ICP and maintain the cerebral perfusion pressure to analyze the relationship between ICP monitoring and prognosis.Results As compared with the control group,there were significant decreases of disability and mortality rate for patients with ICP monitoring (A,B,C group).Especially group C had a better prognosis than the other groups for statistical significance.In addition,the dose and duration of mannitol of group A,B or C were significantly lower than those of the control group (P ＜ 0.05).Conclusion The application of ICP monitoring is capable of reducing mortality,improving prognosis and enhancing success rate of treating severe craniocerebral injury.