Long-term effect of strengthening management under transcranial Doppler monitoring on patients with severe craniocerebral injury during hospitalization
10.3760/cma.j.cn115354-20200714-00560
- VernacularTitle:住院期间TCD监测下强化管理方案对重型颅脑损伤术后患者远期疗效的影响研究
- Author:
Peng CHE
1
;
Zailong ZHANG
;
Ke ZHANG
Author Information
1. 咸阳市第一人民医院神经外科一病区 712000
- Keywords:
Severe craniocerebral injury;
Transcranial Doppler ultrasound;
Strengthening management;
Long-term prognosis
- From:
Chinese Journal of Neuromedicine
2021;20(5):511-515
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the long-term influence of strengthening management under transcranial Doppler (TCD) monitoring in prognosis of patients with severe craniocerebral injury during hospitalization.Methods:According to the randomized parallel controlled clinical trial, from June 2016 to December 2019, 84 patients from First Ward and Neurological Intensive Care Unit of Department of Neurosurgery, Xianyang First People's Hospital, 12 patients from Third Surgical Department, Chinese Medicine Hospital of Linqu County, and 10 patients from First Brain Surgical Department, Chinese Medicine Hospital of Linqu County were randomly divided into control group and observation group ( n=53). Patients in the control group used postoperative management plan proposed by BTF Guidelines for Severe Traumatic Brain Injury (4 th Edition) , and patients in the observation group accepted strengthening management plan formulated by our research group on the basis of treatment in the control group: TCD monitoring of middle cerebral artery and extracranial internal carotid artery was daily used to record or calculate blood pressure, systolic peak velocity, end-diastolic velocity, vascular resistance index, mean arterial pressure, noninvasive cerebral perfusion pressure, cerebral vascular resistance, noninvasive intracranial pressure, and Lindegaard index; and individualized strengthening management was given according to the monitoring indicators. The average length of hospitalization, proportion of subdural effusion during hospitalization, and Glasgow outcome scale-extended (GOSE) scores at 6 months after injury were compared between the two groups. Results:The average length of hospitalization ([20.7±4.2] d) and proportion of subdural effusion during hospitalization (9.4%) in the observation group were significantly lower than those in the control group ([28.2±4.4] d, 20.7%, P<0.05). The GOSE scores at 6 months after injury (5.5±1.2) were significantly higher than those in the control group (3.2±0.9, P<0.05). Conclusion:Strengthening management under TCD monitoring during hospitalization can more effectively improve the long-term prognosis of patients with severe craniocerebral injury.
