The Application Of Continuous Intracranial Pressure Monitoring In The Treatment Of Moderate-severe Craniocerebral Trauma

Object: To evaluate the application value of invasive intracranial pressure monitoring in the therapeutic guidance and prognosis of moderate-severe craniocerebral trauma.Method:The patients from Nanjing Li Shui people’s hospital,with moderate-severe craniocerebral trauma,were collected between November 2016 and October 2017.55 patients in the collection were underwent neurosurgery operation.Screening criteria:1)Each patients with craniocerebral trauma was confirmed by CT and clinical diagnosis.2)The severity of the injury was assessed according to the amount of blood volume,bleeding site and GCS score.3)Other serious injury were excluded,such as heart disease,cerebral vascular malformation,other systemic organ damage and life-threatening diseases.22 cases were Included with admission GCS score in 3 to 5points.10 cases of GCS score is 6-8 points,and the cases of GCS score in 9 to 12 points are 23.There were 8 cases placed the ICP sensor in the ventricle,and 47 cases were put in the parenchymal ICP sensor.According to the prognosis,the research was divided into good prognosis group(GOS 4 ~ 5 points)and poor prognosis group(GOS 1 ~ 3points).The data of these two groups were compared and analyzed to show the relationships between the ICP variation and its impact on operation and prognosis.Result:The good prognosis group included(GOS 5)6 cases(11%)and(GOS4 points)15 cases(28%).The poor prognosis group was composed of severe disability(GOS 3)9 cases(17%),vegetative state(GOS2)7 cases(13%)and death(GOS1)18 cases(31%).Invasive intracranial pressure monitoring was performed in all patients after admission.Two groups of intracranial pressure numerical value in the initial,postoperative changes of the mean and the change of intracranial pressure fluctuations between the two groups were statistically significant(P < 0.01).If the intracranial pressure is maintained at a high level for a long time,the prognosis of patients is often not good.Based on the intracranial pressure monitoring,the usage amount of mannitol in the good prognosis group was less than that of the poor prognosis group.At the same time,there is little relation between the implementation of intracranial pressure monitoring and the complication of craniocerebral trauma.Conclusion:The continuous monitoring of intracranial pressure,in the treatment of moderate-severe head trauma patients,reflect blood flow to the brain and adaptability of the brain tissue timely.According to the ICP value,Sustained high intracranial pressure value indicate poor prognosis.Through continuous intracranial pressure monitoring,it provides a scientific,safe and reliable basis for the use of dehydrated drugs,reducing unnecessary use of clinical dehydrating agents.The duration and location of intracranial pressure monitoring sensor had no significant effect on the prognosis of patients,and there was no significant effect on the occurrence of complications in patients with cerebral trauma.