额叶脑挫裂伤为主的中型颅脑损伤持续颅内压检测的临床意义

Clinical Significance of Successive Intracranial Pressure Monitoring of Moderate Traumatic Brain Injury with Frontal Lobe Contusion

摘要: 目的：探讨以额叶脑挫裂伤为主的中型颅脑损伤持续颅内压检测的临床意义。方法：选取我院2017年5月~2019年8月在新疆军区总医院神经外科住院的37例额叶脑挫裂伤为主的中型颅脑损伤患者，分为有创颅内压监测(ICP)治疗组及未监测常规治疗组，18例行有创颅内压监测治疗，19例行常规治疗。比较两组在治疗期3个月后预后情况(GOS评分)及治疗期间NICU治疗时间比较，临床病情进行性加重及外科开颅手术例数的情况。结果：两组37例患者从在NICU治疗天数、预后情况两方面作对比，ICP治疗组明显优于常规治疗组，两者差异均有统计学意义(p < 0.05)，两组临床病情进行性加重及外科开颅手术例数，有创颅内压监测治疗组例数及例数百分比明显优于常规治疗组。结论：对于额叶损伤为主的中型颅脑损伤，持续有创颅内压监测能时实反应颅内压变化，可以早期诊治，判断病情变化；判断外科开颅时间；预测和改善预后；减少外科开颅手术；减少NICU治疗时间。

Abstract: Objective: To investigate clinical significance of successive intracranial pressure monitoring of moderate traumatic brain injury with frontal lobe contusion. Methods: 37 patients with moderate traumatic brain injury with frontal lobe contusion meeting inclusion criteria treated by the General Hospital of Xinjiang Military Region between May 2017 to August 2019 were retrospectively stud-ied and divided into two groups: invasive intracranial pressure monitoring (ICP) treatment group and non-intracranial pressure monitoring treatment group, with 18 patients receiving invasive in-tracranial pressure monitoring and 19 patients receiving routine treatment. The two groups were compared by the prognosis (GOS score) after 3 months and the treatment time of NICU and clinical condition, as well as the number of surgical craniotomy cases. Results: There was a significant dif-ference between the group of invasive intracranial pressure monitoring and non-intracranial pres-sure monitoring in the treatment time of NICU (p < 0.05). The clinical condition and the number of surgical craniotomy cases in the group of invasive intracranial pressure monitoring were signifi-cantly better than those in non-intracranial pressure monitoring group. Conclusion: Successive in-tracranial pressure monitoring can reflect the changes of intracranial pressure in real time, and can be helpful in early diagnosis and treatment, so as to reduce NICU treatment time.