| Objective:Objective to investigate the effects of intracranial pressure(ICP),brain temperature(BT)and Axillary temperature(AT)on the condition and prognosis of patients with severe brain injury(STBI)and the relationship between ICP,BT and AT.Methods:(1)a prospective study was conducted on 60 patients with craniocerebral injury admitted to the neurosurgery department of youjiang ethnic medical college from December 2017 to November 2019(39 patients received surgery and 21 received conservative treatment).(2)all patients were included to receive intracranial pressure monitoring sensors with brain temperature monitoring function,and GCS,ICP,brain temperature and body temperature were recorded for 10 days.(3)all the collected ICP,brain temperature and body temperature data were correlated with the GCS score for linear regression analysis,and ICP,brain temperature,body temperature and GCS score were compared on the first day,the third day and the tenth day of admission respectively.(4)after 3 months follow-up for all patients,and the follow-up of patients with Glasgow prognostic classification(Glasgow Pprognosis Score,GOS)divided the patients into groups(5 points),good light residual heavy(4),group(3 points),plant group(2 points),death(1),ICP,brain temperature,temperature,respectively,and prognostic score for correlation and linear regression analysis,at the same time on the prognosis of ICP,brain and body temperature are compared.(5)correlation analysis and regression analysis were carried out on the collected ICP,brain temperature and body temperature respectively;Brain temperature and body temperature of the four groups were compared according to the mean ICP values of the patients: A(≤20mm Hg),B(21-30mmhg),C(31-40mmhg)and D(> 40 mm Hg).According to the size of the patients with brain temperature averages are divided into E(37.6 ℃ or higher),F(37 ℃ to 37.5 ℃),G(36.6 ℃ to 37.0 ℃),H(36.1 ℃ to 36.5 ℃),I(35.5 ℃ to 36.0 ℃)five groups,groups of temperature in the comparison.Results:(1)ICP and brain temperature were strongly correlated with GCS,and body temperature was weakly correlated with GCS.Regression analysis showed that ICP and GCS score had a strong negative linear relationship,brain temperature had a strong positive linear relationship with GCS score,and body temperature had a weak linear relationship with GCS score.Beta values were-0.664,0.613,and-0.190,respectively,all P < 0.01.Analysis of variance,the patients in hospital day 1,3 days,10 days of GCS score comparison,10 days > day > 1 day,3 differences statistically significant(F = 66.82,P < 0.01),the comparison of three periods of ICP,10 th day < < 3 days,1 day difference statistically significant(F = 112.4,P < 0.01);For comparison of brain temperature at three time periods,> on day 10,> on day 1 and day 3,the difference was statistically significant(F = 72.44,all P < 0.05).For comparison of body temperature at three time periods,> on day 10 and > on day 1,the difference was statistically significant(P < 0.05).(2)ICP and brain temperature were significantly correlated with the prognosis of the patients,while body temperature was weakly correlated with the prognosis,with r being-0.89,0.777 and 0.425,respectively,all P < 0.01.Regression analysis showed that there was a strong negative linear relationship between ICP and prognosis,a strong positive linear relationship between brain temperature and prognosis,and a weak linear relationship between body temperature and prognosis.Analysis of variance,comparison of ICP in each prognostic group,the good group < light residual group < heavy residual group < plant group < death group,the difference was statistically significant,all P < 0.05.The brain temperature of each prognostic group was compared,and the differences were statistically significant in the death group of the > mild residual > severe residual > plant group(all P < 0.05).Good prognosis of each group,in the comparison of the temperature,light residual temperature below the severely disabled,plant group’s temperature difference is statistically significant(P < 0.05),good group,the light group,the die temperature difference between the three groups have no statistical significance(P > 0.05),heavy residue with plant group,temperature difference between the three groups to compare death group has no statistical significance(P > 0.05).(3)ICP was strongly correlated with brain temperature,while ICP and brain temperature were weakly correlated with body temperature,with r being-0.737,0.269 and-0.296,respectively,all P < 0.01.Linear regression analysis showed that ICP and brain temperature existed in a significantly negative linear relationship,while ICP,brain temperature and body temperature were weakly linear,and Beta was-0.687,0.19 and 0.254,respectively,all P < 0.01.According to the analysis of variance,A(≤20mm Hg),B(21-30mmhg),C(31-40mmhg),and D(> 40 mm Hg)were used in the four groups.A < B and A < C were compared in each group,and the differences were statistically significant(all P < 0.05).However,there was no statistical significance in the comparison between group A and group D,group B and group C,group B and group D,and group C and group D(all P > 0.05).The differences of E < G,E < H and F < G were statistically significant(P < 0.05).There was no statistically significant difference between E and F,E and I,F and H,F and I,and H,G and I(all P> 0.05).Conclusion:(1)ICP and brain temperature have significant effects on the prognosis of patients with severe road brain injury.Increased ICP predicts poor prognosis,while decreased brain temperature predicts poor prognosis,while body temperature has no significant effect on the prognosis.(2)there is a linear correlation between ICP and BT and GCS score,and both ICP and brain temperature have a significant influence on GCS score.With the increase of ICP,the GCS score shows a decreasing trend,while with the increase of brain temperature,the GCS score shows an increasing trend.While there is a weak linear correlation between body temperature and GCS score,body temperature has no significant influence on GCS score.(3)there is a linear correlation between ICP and brain temperature,and ICP has a significant impact on brain temperature,and brain temperature shows a decreasing trend with the increase of ICP.The effect of body temperatureon ICP was limited to the good group with a weak effect.Body temperature had a significant effect on brain temperature,brain temperature increased with the increase of body temperature,but it was restricted to the good group and the light residual group,while body temperature had no significant effect on brain temperature in the heavy residual,plant and death groups.(4)The ICP,brain temperature is one of the factors that affect the prognosis of patients with STBI,ICP,reduce predictor of poor prognosis in patients with brain temperature,and evaluated the patients in ICP,brain temperature can affect changes in GCS score,ICP,brain temperature to reduce both to lower GCS score,ICP and the close relationship between brain temperature at the same time,the limitation and body temperature’s influence on the prognosis and GCS score,low correlation between body temperature and ICP,brain temperature.Therefore,brain temperature can be used as a clinical monitoring indicator to evaluate the condition,prognosis and guide treatment of STBI patients,while whether body temperature can be used as an indicator to evaluate the condition of STBI patients still needs further discussion. |
PDF Full Text Request