中国现代医学杂志2017，Vol.27Issue(1)：115-119,5.DOI:10.3969/j.issn.1005-8982.2017.01.024
ICP联合TCD监测外伤性蛛网膜下腔出血的临床研究
Transcranial Doppler combined with ICP in monitoring traumatic subarachnoid hemorrhage
梅涛 1徐立新 1王蕾 1贾若飞 1王俊 1王年华 1钟晨1
作者信息
- 1. 湖南省常德市第一人民医院 神经外科，湖南 常德 415003
- 折叠
摘要
Abstract
Objective To evaluate treatment guidelines and judgment of prognosis for traumatic subarach-noid hemorrhage (tSAH) by transcranial Doppler (TCD) combined with intracranial pressure (ICP) monitoring. Methods A retrospective study was performed in 45 patients with traumatic subarachnoid hemorrhage who were confirmed on a CT scan. All of the patients received the implantation of intraventricular ICP probe and continuously TCD after admission. Postoperative intracranial pressure and drainage of cerebrospinal fluid were monitored. Then the corresponding treatment strategies were determined in accordance with the initial ICP and TCD value. They were grouped according to cerebral vasospasm (CVS). KPS scores at admission and 6 months after surgery were compared to determine the prognosis. Results Initial ICP value was more than 40 mmHg in 25 patients, among which 24 cases underwent craniotomy, 1 case gave up surgery because of cen-tral exhaustion in the operating room. The 25 patients had different Glasgow Outcome Scale scores including 10 cases who died, 4 cases who remained in a vegetative state, 7 with severe disability, 2 with moderate dis-ability, and 2 with good recovery. In the 8 cases with initial ICP of 20-40 mmHg, 4 underwent craniotomy; 1 patient remained in vegetative state, 1 had severe disability, 1 had moderate disability, and 5 had good reco-very. In the 12 cases with initial ICP of 15-20 mmHg, 11 underwent conservative treatment, 1 received opera-tion on the next day after admission, all had good recovery. There were significant differences in ICP and TCD before and after craniotomy. ICP monitoring combined with TCD obviously improved KPS scores in the tSAH patients without CVS or with mild or moderate CVS. Conclusions Early continuous ICP monitoring combined with TCD has a positive effect in guidance of treatment for patients with tSAH.关键词
外伤性蛛网膜下腔出血/颅内压/经颅多普勒/外科手术Key words
traumatic subarachnoid hemorrhage/intracranial pressure/transcranial Doppler/surgical procedures分类
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梅涛,徐立新,王蕾,贾若飞,王俊,王年华,钟晨..ICP联合TCD监测外伤性蛛网膜下腔出血的临床研究[J].中国现代医学杂志,2017,27(1):115-119,5.
