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[重型颅脑损伤中的颅内压。第二部分:治疗意义与预后]

[Intracranial pressure in severe brain injuries. 2nd Part: Therapeutic interests and prognosis].

作者信息

Born J D, Hans P, Bonnal J

出版信息

Neurochirurgie. 1984;30(5):329-34.

PMID:6521814
Abstract

Sixty-seven patients with severe head injury underwent intracranial pressure (ICP) monitoring (10 extradural and 57 intraventricular). All patients had Liege coma scale (LCS) score of 12 or less. Ventriculitis (E. Coli) occurred in one patient (1,8%). The intraventricular method allows C.S.F. drainage with lowering of I.C.P. even with slit ventricles. After 8 days, if an intracranial hypertension persists, we perform a ventriculo-atrial drainage. Pressure recording is a useful way of following the patient's evolution and a guide for prognosis of survival. If I.C.P. is constantly below 5 torr, then the probability of a bad outcome is great. The study also confirms the high mortality rate (93%) if I.C.P. is greater than 40 torr.

摘要

67例重型颅脑损伤患者接受了颅内压(ICP)监测(10例硬膜外监测,57例脑室内监测)。所有患者的列日昏迷量表(LCS)评分均为12分及以下。1例患者(1.8%)发生了脑室炎(大肠杆菌感染)。脑室内监测方法即使在脑室狭小的情况下也能通过脑脊液引流降低颅内压。8天后,如果颅内高压持续存在,我们会进行脑室-心房引流。压力记录是跟踪患者病情进展的一种有用方法,也是生存预后的一个指导指标。如果颅内压持续低于5托,那么预后不良的可能性很大。该研究还证实,如果颅内压大于40托,死亡率很高(93%)。

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