Objective To explore the operation time and application value of intracranial pressure monitoring in treatment of patients with bifrontal lobe of brain contusion and laceration.Methods Clinical data of 66 patients with bifrontal lobe of brain contusion and laceration from 2005 to 2010 were studied retrospectively.66 patients were underwent bifrontal decompressive craniectomy.35 cases treated by bifrontal decompressive craniectomy combined with intracranialpressure monitoring were included in monitoring group.31 cases treated only by bifrontal decompressive craniectomy were included in control group.The clinical efficacy of both two groups were compared 12 months later.The data were retrospectively analyzed in order to summary the clinical characteristics,operational time,application value of intracranial pressure monitoring and prognosis.Results 8 cases got emergence operation,58 cases were operated during the medical treatment because their situation developed worse gradually.All of the patients were followed up for twelve months.According to GOS assessment,there are 3 cases died,1 case with persistent vegetative state,2 cases with severe disability,4 cases with moderate disability,25 cases got good recovery in monitoring group.There are 5 cases of dearh,2 case with persistent vegetative state,2 cases with severe disability,6 cases with moderate disability,16 cases got good recovery in control group.The favorable prognosis rate of monitoring group and control group was 71.43% and 51.61%(P＜0.05).Conclusion The situation of many patients with bifrontal lobes brain contusion and laceration will become worse and worse gradually.The doctors should observe the patients carefully and operate on them in time.The bifrontal decompressive craniectomy is an effective method for the surgical management.The intracranial pressure monitoring can dynamically observe ICP,providing the objective and accurate evidence,and improve the prognosis of patients.
WANG Fei
,
ZHU You-hou
,
WU Yi-fang
,
YU Fei
,
LIU Ning-tao
,
HAI Jian
. Exploring the operational time and application value of intracranialpressure monitoring in treatment of patients with bifrontal lobes of brain contusion and laceration[J]. Surgical Research and New Technique, 2013
, 2(1)
: 21
-26
.
DOI: 10.3969/j.issn.2095-378X.2013.01.006
[1] 夏咏本,李爱民,颜士卫,等.冠切双额大骨瓣开颅术在双额叶脑挫裂伤中的运用[J].中国临床神经外科杂志,2010,15(12):742-744.
[2] 朱青峰,王国芳,周志国.持续颅内压监测在双额叶脑挫裂伤致中央型脑疝救治中的应用[J].中国实用神经疾病杂志,2012,15(14):39-41.
[3] 潘云峰,范曙强.颅内压监测在双额叶脑挫裂伤中的运用体会[J].浙江创伤外科,2010,15(5):668-669.
[4] 董吉荣,胡旭,王玉海,等.双侧平衡去骨瓣减压术对特重型颅脑伤致双瞳散大患者的救治[J].中华神经外科杂志,2011,27(6):706-709.
[5] Cumings JL.The neuropsychiatric inventory:assessing psycho-pathology in dementia patients[J].Neurology,1977,48(6):10-16.
[6] 王宏国,蔡强,杜浩,等.中央型脑疝的临床特点及诊治[J].中国临床神经外科杂志,2011,16(16):340-342.
[7] 王胜,吴楚君,周朝辉,等.综合治疗双侧额叶脑挫裂伤的体会[J].中国实用神经疾病杂志,2008,11(1):34-36.
[8] 郭剑锋,王占祥,谭国伟,等.前额底脑挫裂伤的手术时机探讨[J].中华神经外科疾病研究杂志,2007,6(1):59-62.
[9] 只达石.重型颅脑损伤救治规范[M].北京:人民卫生出版社,2002:23-24.
[10] 张赛,涂悦,赵明亮,等.大骨瓣减压术治疗颅脑创伤后顽固性高颅压[J].中华神经外科杂志,2011,27(2):169-173.
[11] Farahvar A,Gerber LM,Chiu YL,et al.Response to intracranial hypertention treatment as a predictor of death in patients with severe traumatic brain injury [J].J Neurosurg,2011,114(5):1471-1478.
