本文關(guān)鍵詞： 顱內(nèi)壓監(jiān)測 重型顱腦外傷 格拉斯哥預后評分 日常生活活動能力評分 神經(jīng)功能評分　出處：《中國現(xiàn)代醫(yī)學雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的探討持續(xù)性顱內(nèi)壓監(jiān)測應用于急性重型顱腦外傷治療的意義。方法選取2013年1月-2016年1月收入該院的急性重型顱腦外傷患者300例,采用隨機數(shù)字表法將入選病例分為監(jiān)測組和對照組,對照組行常規(guī)治療,監(jiān)測組患者入院2 d內(nèi)行有創(chuàng)持續(xù)顱內(nèi)壓監(jiān)測,并根據(jù)監(jiān)測結(jié)果給予相應治療措施。在對照組及監(jiān)測組患者分別接受不同監(jiān)護及治療措施30 d后為時間點,進行格拉斯哥預后評分(GOS)、神經(jīng)功能評分(NIHSS)、日常生活活動能力評分(ADL)及并發(fā)癥及死亡率評定。結(jié)果監(jiān)測組的GOS、ADL及NIHSS與對照組相比,差異有統(tǒng)計學意義(P0.05),監(jiān)測組的GOS格拉斯哥評分及日常生活活動能力評分較對照組高,監(jiān)測組的神經(jīng)功能評分較對照組低。監(jiān)測組的電解質(zhì)紊亂、急性腎損害、消化道出血、尿路感染、肺部感染、顱內(nèi)感染、血腫發(fā)生率及死亡率與對照組相比差異有統(tǒng)計學意義(P0.05),監(jiān)測組的電解質(zhì)紊亂、急性腎損害、消化道出血、尿路感染、肺部感染發(fā)生率及死亡率均較對照組低,顱內(nèi)感染及血腫發(fā)生率較對照組高。結(jié)論持續(xù)性顱內(nèi)壓監(jiān)測對于急性重型顱腦外傷患者恢復其正常生活、保護其日常生活活動能力、降低神經(jīng)受損程度以及降低并發(fā)癥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.
【作者單位】： 蘇州大學附屬第二醫(yī)院神經(jīng)外科;
【分類號】：R651.15
【正文快照】： 重型顱腦外傷屬于多發(fā)病、常見病,是青壯年人群致殘致死的主要原因之一[1]。重型顱腦外傷后會導致繼發(fā)性顱內(nèi)壓增高,從而引起一系列病生理改變,如腦水腫、腦組織缺血缺氧及腦組織灌注不足等,進一步導致顱內(nèi)高壓加重,形成惡性循環(huán)[2]。近年來逐步開始應用的持續(xù)性顱內(nèi)壓監(jiān)測可

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