摘要
目的探讨脑室型颅内压监测在弥漫性轴索损伤(DAI)患者临床治疗中的安全性和有效性。方法将本院65例DAI患者分为常规治疗组及颅内压监测组,比较两组患者的临床治疗过程及预后。结果与常规治疗组比较,颅内压监测组甘露醇使用时间、ICU入住时间、住院时间更短(P<0.05),甘露醇使用量更少,气管切开率、肺部感染率更低(P<0.05),长期随访GOS评分预后良好(4〜5分)患者较多(P<0.05),预后不良(1~3分)患者更少(P<0.05),而两组再出血、颅内感染、30 d内死亡率、慢性脑积水差异无统计学意义(P>0.05).结论对DAI患者实施脑室型颅内压监测,能够调整脑脊液引流量,快速廓清血性脑脊液,降低颅内压,精准指导甘露醇使用,有利于迟发性颅内血肿的早期诊断及手术决策,提高患者生存率,改善不良预后,具有重要的临床价值。
Objective To explore the safety and efctivenes of intravenuicular inracranial pressure monitoring in the clinical ureatment of difuse axonal injury(DAI)patients.Methods 65 PAI patients in our hospial were divided into two groups:routine treatment group and intracanial pressure monitoring group.Results Compared with the routine treatment goup,the time of mannitol use,ICU suay and hospital say in ICP monitoring group were shorter(P<005).There were less mannitol use,lower tracheotomy rate and lung infection rate(P<0.05),more paticnts with good prognosis(GOS4-5)and less patiens with poor prognosis(GOS 1-3)in ICP monitoring group(P<0.05).There was no significant diference in infecion,risk of death within 30 days and chronic hydrocephalus(P>0.05).Conclusion The monitoring of ventricular intracranial pressure in DAI patients can adjust the flow of cerebrospinal fuid,quickly clear the blood cerebrospinal fluid,reduce the intracranial pressurer,acuratly guide the use of mannitol,which is conducive to the early diagnosis and surgical decision-making of delayed inoracranial hematoma,improve the survival rate of patients and improve the poor progmosis which has important clinical value.
出处
《浙江临床医学》
2021年第2期174-176,共3页
Zhejiang Clinical Medical Journal
关键词
弥漫性轴索损伤
脑室型颅内压监测
脑水肿
预后
Diffuse axonal injury
Ventricular intracranial pressure monitoring
Brain edema
Prognosis