本文關(guān)鍵詞： 顱內(nèi)壓監(jiān)測(cè) 重型顱腦外傷 格拉斯哥預(yù)后評(píng)分 日常生活活動(dòng)能力評(píng)分 神經(jīng)功能評(píng)分　出處：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年11期 　論文類(lèi)型：期刊論文

【摘要】：目的探討持續(xù)性顱內(nèi)壓監(jiān)測(cè)應(yīng)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(jī)數(shù)字表法將入選病例分為監(jiān)測(cè)組和對(duì)照組,對(duì)照組行常規(guī)治療,監(jiān)測(cè)組患者入院2 d內(nèi)行有創(chuàng)持續(xù)顱內(nèi)壓監(jiān)測(cè),并根據(jù)監(jiān)測(cè)結(jié)果給予相應(yīng)治療措施。在對(duì)照組及監(jiān)測(cè)組患者分別接受不同監(jiān)護(hù)及治療措施30 d后為時(shí)間點(diǎn),進(jìn)行格拉斯哥預(yù)后評(píng)分(GOS)、神經(jīng)功能評(píng)分(NIHSS)、日常生活活動(dòng)能力評(píng)分(ADL)及并發(fā)癥及死亡率評(píng)定。結(jié)果監(jiān)測(cè)組的GOS、ADL及NIHSS與對(duì)照組相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05),監(jiān)測(cè)組的GOS格拉斯哥評(píng)分及日常生活活動(dòng)能力評(píng)分較對(duì)照組高,監(jiān)測(cè)組的神經(jīng)功能評(píng)分較對(duì)照組低。監(jiān)測(cè)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(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05),監(jiān)測(cè)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(duì)照組低,顱內(nèi)感染及血腫發(fā)生率較對(duì)照組高。結(jié)論持續(xù)性顱內(nèi)壓監(jiān)測(cè)對(duì)于急性重型顱腦外傷患者恢復(fù)其正常生活、保護(hù)其日常生活活動(dòng)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(xué)附屬第二醫(yī)院神經(jīng)外科;
【分類(lèi)號(hào)】：R651.15
【正文快照】： 重型顱腦外傷屬于多發(fā)病、常見(jiàn)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(huì)導(dǎo)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(jìn)一步導(dǎo)致顱內(nèi)高壓加重,形成惡性循環(huán)[2]。近年來(lái)逐步開(kāi)始應(yīng)用的持續(xù)性顱內(nèi)壓監(jiān)測(cè)可

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