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重型颅脑损伤持续颅内压及脑灌注压监护与预后的关系 |
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李珍兰 刘玲 熊艳梅 叶彩云 袁敬芳 吕文秀
摘要 对50例重型颅脑损伤患者进行颅内压(ICP)与脑灌注压(CPP)连续监测，并根据监测结果及时采取相应的治疗护理措施(监护组)；与50例未行连续监测，按常规临床观察进行治疗护理的患者(对照组)进行预后比较。结果表明：监护组并发症比对照组明显减少，致残率及死亡率明显低于对照组(P＜0.01)。观察ICP、CPP结果显示：ICP＜2.00 kPa、CPP＞9.33 kPa的患者预后良好；ICP＞ 8.00kPa、CPP＜6.67 kPa者预后较差。提示：对重型颅脑损伤患者施行连续ICP、CPP监护，有利于了解病情变化，及时采取有效的治疗护理措施，对降低致残率及死亡率具有临床应用价值。
关键词 颅脑损伤；颅内压；脑灌注压；预后
Continuous Monitoring of ICP, CPP and Their Relation to Prognosis of Severe Brain Injury
Li Zhenlan, Liu Lin, Xiong Yanmei, Ye Caiyun, Yuan Jingfang, Lü Wenxiu
Huanggang First People＇s Hospital of Hubei Province, Huanggang 436100
Abstract Continuous monitoring of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) was performed in 50 patients with severe brain injury. According to the monitoring results, corresponding treatment and nursing care were given timely (group Ⅰ).Other 50 patients without undergoing continuous montoring obtained the treatment and nursing in terms of ordinary clinical observation and served as control group (groupⅡ).The prognosis comparison was conducted between the two groups. The results showed that in group I the patients with complications were decreased significantly as compared with group Ⅱ and disability rate and mortality obviously lower than in group Ⅱ(P＜0.01).The ICP and CPP measurements demonstrated that the patients with ICP＜2.00 kPa and CPP＞9.33 kPa had a good prognosis,while the patients with ICP＞8.00 kPa and CPP＜6.67 kPa had a worse prognosis. It was suggested that continuous ICP and CPP monitoring for the patients with servere brain injury was of great clinical value for knowing the diseased conditions, carrying out effective treatment and reducing the disability rate and mortality.
Key words brain injury; intracranial pressure; cerebral perfusion pressure; prognosis
急重型颅脑损伤常引起颅内压(ICP)增高和脑灌注压(CPP)降低。持续ICP、CPP监护对指导治疗和判断预后及提高疗效具有重要作用。我科1995年1月至1998年1月对50例重型颅脑损伤患者进行了持续ICP和[1] [2] 下一页
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