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| Clinical study of continuous intracranial pressure and cerebral perfusion pressure monitoring in patients with severe craniocerebral injury |
| LIN Li-chao YANG Jian-xiong YE Zhi-qi HUANG Jian-bin ZHANG Jian-wei |
| Department of Neurosurgery,Heyuan People′s Hospital in Guangdong Province,Heyuan 517000,China |
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Abstract Objective To investigate the clinical effect of continuous intracranial pressure (ICP)and cerebral perfusion pressure (CPP)monitoring in patients with severe craniocerebral injury,and to provide guidance for clinical practice. Methods 80 patients with severe craniocerebral injury admited to hospital within 72 h after injury were selected as study object by random envelope extraction in our hospital from October 2015 to December 2016,they were randomly divided into control group and experimental group,40 cases in each group.Patients in the control group were not given monitoring,patients in the experimental group were given continuous ICP and CPP monitoring,in which 16 cases were admitted within 24 h after injury,24 cases were admitted within 24-72 h after injury,and patients in the experimental group were divided into group A (CPP≥9.33 kPa)and group B (CPP<9.33 kPa)according to CPP level of the admission,the clinical effects of ICP and CPP monitoring were compared.Results The good recovery rate of patients in the experimental group was 62.50%,significantly higher than that in the control group (40.00%),severe disability rate (5.00%)was significantly lower than that in the control group(20.00%),the mortality rate(7.50%)was significantly lower than that in the control group(25.00%),the clinical effect of the experimental group was better than that of the control group, and the difference was statistically significant(P<0.05).Within 24 h after injury,MABP,PaO2in group A was significantly higher than that in group B (P<0.05),there was no obvious difference in other indexes(P>0.05);within 24-72 h after injury,ICP in group A was significantly lower than that in group B(P<0.05),there was no obvious difference in other indexes(P>0.05).Conclusion The implementation of continuous ICP and CPP monitoring is helpful to improve the prognosis of patients with severe craniocerebral injury,at the same time reasonable intervention measures should be implemented combined with the actual situation of patients.
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| [1] |
甘元华，温权，齐浩文，等.有创颅内压监护在重型颅脑创伤手术后治疗中的临床意义[J].贵州医药，2016，40（10）：1064-1065.
|
| [2] |
Qvarlander S，Malm J，Eklund A.CSF dynamic analysis of a predictive pulsatility-based infusion test for normal pressure hydrocephalus[J].Med Biol Eng Comput，2014，52（1）：75-85.
|
| [3] |
周强，蒋栋毅，陈寒春，等.持续颅内压监护和脑灌注压监护在重型颅脑损伤中的临床应用[J].中国现代手术学杂志，2011，15（5）：386-388.
|
| [4] |
王宏宇，赵迪，刘东，等.亚低温治疗老年重型颅脑创伤患者的临床疗效[J].中华行为医学与脑科学杂志，2016，25 （4）：350-353.
|
| [5] |
金保哲，张新中，周文科，等.重型颅脑创伤开颅术中急性脑膨出原因分析与对策[J].中华神经外科杂志，2014，30 （3）：242-244.
|
| [6] |
杨松斌，吕庆伟，周晶，等.血浆Clara细胞蛋白浓度与重型颅脑创伤并发急性肺损伤的相关分析[J].中华神经外科杂志，2014，30（3）：248-251.
|
| [7] |
李晶，刘丽群.重型颅脑创伤患者心电图变化与预后的相关性研究[J].中国实用神经疾病杂志，2016，19（18）：36-38.
|
| [8] |
于洋，张琳瑛，闫华，等.重型颅脑创伤早期康复治疗研究进展[J].中国现代神经疾病杂志，2014，14（6）：548-551.
|
| [9] |
何森，何永生.重型颅脑创伤去骨瓣减压术后硬膜下积液的研究进展[J].中华创伤杂志，2016，32（11）：1039-1042.
|
| [10] |
张赛，陈旭义.重型颅脑创伤的救治经验与思考[J].中华神经外科杂志，2015，31（2）：112-114.
|
| [11] |
胡群亮，葛云飞，闫改军，等.重型颅脑创伤去骨瓣减压术后脑积水的治疗方案选择[J].中华创伤杂志，2015，31 （12）：1063-1067.
|
| [12] |
秦德广，黄文勇，杨灵，等.持续颅内压监测在重型颅脑创伤去骨瓣减压术后治疗中的作用[J].中华创伤杂志，2016，32（7）：612-614.
|
| [13] |
李旭，韩媛，李巍，等.血清降钙素原在重型颅脑创伤合并脓毒症早期诊断中的价值[J].中华神经外科杂志，2015，31（10）：1005-1006.
|
| [14] |
刘涛，尹成.神经外科重型颅脑创伤急性期血压变异性对患者近期预后的影响研究[J].脑与神经疾病杂志，2016，24（9）：566-569.
|
| [15] |
杨细平，张馨予，涂悦，等.限制性液体复苏对重型颅脑创伤患者凝血功能的影响[J].中华创伤杂志，2015，31（8）：681-685.
|
| [16] |
范维佳，黄慧玲，蔡英，等.牛磺酸对重型颅脑创伤大鼠线粒体呼吸链酶活性的影响[J].中华创伤杂志，2015，31 （3）：254-258.
|
| [17] |
杜春奇，王岭梅，赵卫兵，等.颅内压监测在重型颅脑创伤手术中的应用[J].检验医学与临床，2016，13（17）：2550-2551.
|
|
|
|
