Clinical value of monitoring subdural intracraniai pressure in post-operative patients with severe brain injury
10.3760/cma.j.issn.1001-8050.2009.08.233
- VernacularTitle:硬膜下颅内压监护在重型颅脑损伤术后的临床应用
- Author:
Zaifeng CHEN
;
Xinlong XU
;
Xiaojun FU
;
Xiaojie WEI
;
Hongsong PAN
;
Qinsong XIE
- Publication Type:Journal Article
- Keywords:
Subdural space;
Brain injuries;
Intracranial pressure;
Prognosis
- From:
Chinese Journal of Trauma
2009;25(8):729-732
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of subdural intracranial pressure (ICP) monito-ring in post-operative patients with severe brain injury. Methods A total of 100 patients with severe brain injury treated with craniotomy were randomly divided into ICP monitoring group (n=50) and rou-tine treatment group (n = 50). In ICP monitoring group, the treatment methods were adjusted according to the changes of ICP, whereas the patients in routine treatment group underwent general treatment ac-cording to standard neurosurgical protocol. Results Patients in ICP monitoring group received mannitol for eight days, with the average dosage of 950 g. Marmitol was administered to patients in routine treat-ment group for 12 days, with average dosage of 1 450 g. There was statistical difference in aspects of time duration and mannitol dosage between two groups (P <0.01). Of all patients in ICP monitoring group, four were found with electrolyte disturbance (8%), seven with acute renal failure (14%), four with stress ulcer (8%) and eight with pulmonary infection (16%). The corresponding numbers of patients in routine treatment group were nine (18%), 14 (28%), five (10%) and nine (18%), respectively. The occurrence of electrolyte disturbance and acute renal failure between two groups showed significant statistical difference (P < 0.05), while the occurrence of stress ulcer and pulmonary infection were be-yond of statistical difference between two groups (P > 0.05). The post-operative initial ICP level was positively correlated with mortality rate (P <0.01). All patients were followed up for three months post-operatively. In ICP monitoring group, 27 patients (26%) obtained good prognosis without any disability (54%), 13 were under mild disability, two (4%) under severe disability, three (6%) under vegeta-tive state and five (10%) died . In the routine treatment group, 17 patients (34%) were with good prognosis without any disability , six (12%) with mild disability , six (12%) with severe disability, eight (16%) under vegetative state and 13 (26%) died. The ICP monitoring group had better prognosis than the routine treatment group(P < 0.05). Conclusion Continuous ICP monitoring postoperatively in severe brain injury patients is valuable in reducing mortality, complication and improving the prognosis.
