The Inquiry Of Using ICP Monitoring For Postoperative Patients ITH Severe Intracranial Hematoma

ObjectiveThe purpose of conducting the ICP monitoring for the postoperative patients (GCS scal≤8) is to inquire the value of using ICP monitoring, comprehend the regular pattern of ICP and blood sodium, and get clinical refrence for the treatment of hyper-intracranial pressure.Methods of researchFrom Jun.2010to Nov.2011,30cases of cerebral hematoma werediagnosed (inculded traumatic and nontraumatic hemorrhage,preoperative GCSscal≤8) in Dong’e People’s Hospital. Prospective study was performde beforethe operations and ICP monitoring was conducted after that. Differenttherapeutic methods were choosen according to different ICPdata.We recordedICP data per hour and tested blood sodium at six every morning.For compareison,we also studied another30postoperative patients without conducting ICPmonitoring, in order to inquire the value of prognosis judge by using ICPmonitoring and acquaint the changing regularity of ICP in a week and bloodsodium within two weeks after operation.Rseults1.Results of treatment:we evaluated the effect of therapy after3monthsaccording to the GOS standard. In monitoring team,14cases of good recovery(46.7%)，4cases of residual light(13.3%),4cases of severe disability(13.3%)， plant survival of5cases(16.7%) and3cases of death(10%); In contrasted team，6cases of good recovery(20%),5cases of minor disability(16.7%),6cases of severe disability(20%)，5cases of plant survival(16.7%) and mortalitywas8(26.6%).The data were analyzed by SPSS13.0,and two samples were examined by Mann-Whitney.The results of two groups were significantlydifferent(Z=2.168,P<0.05).The monitoring team had higher rehabilitation rate,however,the no-monitoring team had higher mortality,as a result, the treatmenteffect of monitoring team was more satisfactory.2.The changing regularity of ICP within the1st week after operation:Bydrawing the ICP changing graph of30severe interacranial hematoma patients,ithad been proved that24cases had the highest ICP from the third day to thefifth day,and then the data began to fall back at the fifth day,which wasaccordant with the changing regularity of cerebral edema.But other6cases,ICP varyed frequently and had no regulations.The top ICP could reach74mmHg.The prognosis of these patients was poor:3cases of them gotvegetative status and the other3dead.3.The changing regularity of blood sodium within the2nd weeks afteroperation: By discribing the blood sodium changing graph of30severe interacranial hematoma patients,we came to a conclusion, bloodsodium maintained normal or mild rising.The fastigium of blood sodiumappeared from the second day to the fourth day after operation. The low ebb ofblood sodium appeared from the eighth day to the twelfth day.The lowest wasin the eleventh day.The blood sodium of all the patients recovered normal aftersupplying sodium.Conclusion:We draw the conclusion that ICP monitoring has the significant meaningfor the treatment of severe intracranial hematoma patients after operation,for itcan help us use clinical medicine correctly and acquaint the regular pattern ofICP and blood sodium, which is extraordinarily meaningful for judging ofpatients’clinical condition.