Crockard H A
J Trauma. 1975 Apr;15(4):339-47. doi: 10.1097/00005373-197504000-00011.
Intracranial pressure (ICP) was recorded following gunshot wounds of the brain in 20 patients, and in 11 of them within an hour of injury, during resuscitation. In six who were bleeding profusely, both ICP and blood pressure were low, and they required massive transfusion, with successful outcome in two. Four others presented with small wounds and high ICP. Others, with minimal damage, had "normal" pressures, but this could be affected adversely by coughing, struggling, and minor degrees of respiratory obstruction. Immediate endotracheal intubation, muscle relaxation, and mechanical ventilation prevented such deterioration. Controlled ventilation was continued postoperatively and seemed to control ICP in survivors. It is suggested that the very labile post-traumatic condition of such patients can be improved by adequate resuscitation, immediate intubation, and controlled ventilation; ICP monitoring is valuable pre- and postoperatively in assessing treatment.
对20例脑枪伤患者进行了颅内压（ICP）记录，其中11例在受伤后1小时内复苏期间进行了记录。6例大出血患者的ICP和血压均较低，需要大量输血，其中2例治疗成功。另外4例伤口较小但ICP较高。其他损伤轻微的患者颅内压“正常”，但咳嗽、挣扎和轻度呼吸道梗阻可能会对其产生不利影响。立即进行气管插管、肌肉松弛和机械通气可防止这种恶化。术后持续进行控制通气，似乎能控制幸存者的ICP。建议通过充分复苏、立即插管和控制通气来改善此类患者创伤后极不稳定的状况；ICP监测在术前和术后评估治疗中具有重要价值。
