Significance Of Intracranial Pressure Monitoring In The Treatment Of Adult Patients Of Traumatic Brain Injury In Primary Hospitals In China

Objective:Traumatic brain injuries(TBI)is a common disease in neurosurgery with high mortality and disability rate.Intracranial pressure management is the key to traumatic brain injuries.The current guidelines for ICP management are controversial for clinical guidance.This study explored a new idea for ICP management in patients with traumatic brain injuries by reviewing the cases of traumatic brain injuries in Longgang Central Hospital in the past three years.Methods: To collect the relevant information of patients with traumatic brain injury in recent 3 years,compare the difference of ICP peak value and ADL score under different degree of illness and different decision-making level,and compare the relationship between ICP peak value and patient prognosis through ROC curveResults: There was a negative correlation between the peak value of ICP and ADL(R=-0.4775 p < 0.0001).There was a positive correlation between GCS and ADL(R=0.5409 p < 0.0001).Multiple linear regression indicated that both the peak value of GCS and ICP were important indexes reflecting the progression of the disease When GCS ≥ 9,there was no significant difference in ICP peak value and ADL score between surgical treatment and conservative treatment;There was no significant difference in prognosis between ICP monitoring and emergency operation When 8 ≥ GCS ≥ 6,there was no significant difference in prognosis between limited operation and emergency operation monitored by ICP When GCS < 6,ICP peak value ≥ 30 mm Hg,the prognosis is very poor,and most of them are plant survival or death The peak value of ICP < 30 mm Hg,the prognosis is relatively good,and the life is not high.Most of them are severe dependence ICP peak value > 37.5 mm Hg in patients with GCS ≥ 6 indicates serious neurological impairmentConclusion: At GCS≥9,we should give ICP monitoring to patients with traumatic brain injuries,and when ICP does not reach the warning value(37.5mm Hg in this study),conservative treatment can be given first,and if the disease progresses,surgery to reduce intracranial pressure.8≥GCS≥6,improve preoperative preparation under ICP monitoring,and the operation is time-limited.At GCS<6,the overall prognosis is poor,and the ICP <30mm Hg is maintained as much as possible to obtain a relatively good prognosis.