Rallis Dimitrios, Poulos Panagiotis, Kazantzi Maria, Kalampalikis Panagiotis
Pediatric Intensive Care Unit, "Aghia Sophia" Children's Hospital, Athens, Greece.
J Pediatr Intensive Care. 2018 Mar;7(1):33-38. doi: 10.1055/s-0037-1603825. Epub 2017 Jun 19.
Decompressive craniectomy (DC) is considered a rescue therapy in patients with traumatic brain injury (TBI) with increased intracranial pressure (ICP). In this retrospective study, we examined the impact of craniectomy on ICP in children with severe TBI and their neurological outcome. A total of 14 patients were enrolled. Peak ICP was significantly lower (31 ± 2.9 to 19 ± 4.6, < 0.001) and minimum cerebral perfusion pressure (CPP) higher (41 ± 10.5 to 58 ± 11.4, < 0.001) postcraniectomy. The survival rate was 71%. However, 57% of our cohort had a poor neurological outcome at 6 months postinjury. In conclusion, although rescue DC was effective in controlling ICP and CPP, the long-term neurological outcome remained poor.
减压性颅骨切除术（DC）被认为是治疗颅内压（ICP）升高的创伤性脑损伤（TBI）患者的一种挽救性疗法。在这项回顾性研究中，我们研究了颅骨切除术对重度TBI儿童颅内压及其神经功能结局的影响。共纳入14例患者。颅骨切除术后，ICP峰值显著降低（从31±2.9降至19±4.6，P<0.001），最低脑灌注压（CPP）升高（从41±10.5升至58±11.4，P<0.001）。生存率为71%。然而，我们队列中有57%的患者在受伤后6个月时神经功能结局较差。总之，尽管挽救性DC在控制ICP和CPP方面有效，但长期神经功能结局仍然较差。
