The Role Of Intracranial Pressure Monitoring In Severe Craniocerebral Injury

objective:to analyze and discuss the role of intracranial pressure monitoring in severe traumatic brain injury, for the future of the craniocerebral trauma treatment and care to provide certain theoretical basis. Methods:selection of 60 patients admitted in the NO.94 hospital of the People’s Liberation Army(PLA) neurosurgery severe cra niocerebral injury patients as the research object, according to the hospital ethics committee approval, and the patient’ families agree cases randomly divided into observation group and control group, 30 cases in each group. the method of intracranial pressure monitoring in patients in ICP group after operation,by the nursing staff to record every hour changes of the intracranial pressure, Patients in the routine group to implement the routine monitoring method, two groups of patients respectively according to their respective monitoring method, based on the principle of severe craniocerebral trauma treatment, rehabilitation of patients in the two groups were compared, found again surgery time and the corresponding prognosis and treatment of mannitol, ICP correlation and non correlation complications occurrence condition changes. Results:1.The Glasgow outcome score curative effect of two groups of patients in different methodstake care after 3 months. In ICP group good in 21 cases(70.0%), mild disability in 4 cases(13.3%), severe disability in 2 cases(6.7%), moderate disability in 2 cases(6.7%), death in 1 case(3.3%); and routine group in good 10 cases(33.3%), moderate disability in 4 cases(13.3%), severe disability in 6 cases(20.0%), mild disability in 5 cases(16.7%), death in 5 cases(16.7%), ICP patients of rehabilitation is superior to the conventional group, two groups score difference has statistical significance(P < 0.05). 2.In most patients with ICP ICP were observed by ICP group after 7 da ys ICP changes. It is found that there is a certain rule, and from the ICP variation can understand patients may exist in the prognosis of patients with intracranial pressure in craniocerebral surgery after 12 hours began to appear slightly elevated ICP in 15 ~ 20 mm Hg) after 48 hours appear around the peak, most of the patients in 20 ~ 30 mm Hg fluctuations, the peak appeared in the 3-5 days, the fluctuation of ICP value in 25 ~ 30 mm Hg,some patients ICP reached 35 to 40 mm Hg, the part of the patient progno sis is good, part of the patients after 1 to 4 hours of intracranial pressure increases as high as 30 to 40 mm Hg, suggesting that may be required reoperation treatment. 3.ICP group was found in 7 cases required reoperation for patients, the time for 2.2±0.8(H) and conventional group found that needed to surgery patients in 8 cases, the time for 3.4±1.1(H), after surgery, the ICP group in Glasgow O utcome Score(GOS) light disability in 2 cases, severe disability in 2 cases, plant survival in 2 cases, 1 case died, conventional group 1 had severe disability, plant survival in 4 cases, 3 cases died, the two groups of patients found again operative time and prognosis were statistically significant(P < 0.05). 4.ICP group the dosage of mannitol for 951.0±325.4(g), complicated with acute renal function not all 3 cases(10%), the dosage of mannitol in the routine group for 1260.0±635.7(g), complicated with acute renal function is not all of the 10 cases(33.3%), respectively, were statistically analyzed and were statistically significant(P < 0.05). 5.ICP group occurred intracranial infection in 1 case(3.3%), the cable travel around new hemorrhage cases(0%) and routine group occurred intracranial infection in 2 cases(6.7%), compared with no statistical significance(P > 0.05). Conclusion:1.Application of ICP monitoring can improve the prognosis of patients with rehabilitation in patients with severe craniocerebral injury. 2. Within 7 days after the operation of severe craniocerebral injury, intracranial pressure changes exist certain regularity, from changes to assessment of patient’s condition and prognosis of rehabilitation. 3. In the changes of the disease, the ICP group found that the time of reoperation was significantly advanced, and early surgical tre atment could improve the prognosis of the patients. 4.In the application of intracranial pressure monitoring, can reduce the dosage of mannitol andreduce the complications of acute renal insufficiency. 5. In the craniot omy placed parenchymal intracranial pressure probe and ICP related complications(intracranial infection, hematoma formation, etc.) occur rate does not increase.