Kostić Aleksandar, Stefanović Ivan, Novak Vesna, Veselinović Dragan, Ivanov Goran, Veselinović Aleksandar
University Clinical Centre Nis, Nis, Department of Neurosurgery.
Med Pregl. 2011 Sep-Oct;64(9-10):461-5.
Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (chi2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student's t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient's intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.
由于没有前瞻性随机研究，就不可能对颅内压监测的重要性有明确的态度，本研究旨在探讨颅内压监测及以颅内压为导向的治疗对重型颅脑创伤患者的预后影响，并确定开始治疗的最佳颅内压值。本研究中治疗了两组患者，一组由32例接受颅内压监测的患者组成，对照组为29例未接受颅内压监测的患者。该研究为前瞻性研究，分组随机。颅内压监测组患者的生存率为53%，对照组为34%，两组生存率差异无统计学意义（χ2=2.11；p=0.15；p>0.05）。死亡的颅内高压患者平均颅内压为27mmHg，而存活患者的平均颅内压显著较低（学生t检验：t=2.91；p=0.008；p<0.01），为18mmHg。我们建议在监测2小时内患者颅内压超过18mmHg时开始以颅内压为导向的治疗。
