2 / 2016-07-08 21:01:24

Treatment for acute craniocerebral trauma with invasive intracranial pressure combined with transcranial Doppler monitoring (with a report of 163 cases)

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Objective To explore the clinical guidance and prediction of prognosis of invasive intracranial pressure (ICP) combined with transcranial Doppler (TCD) monitoring in treatment for patients with acute craniocerebral trauma. Methods A total of consecutive 163 patients with acute craniocerebral trauma admitted in our department accepting invasive ICP combined with TCD monitoring between Jan 2010 and Jun 2014 were enrolled in this retrospective study. The relationship between prognosis and ICP value as well as pulse index (PI) at admission and 3 days post-operation or after admission was analyzed. Results According to the Glasgow outcome score (GOS) 6 months after injury, among all the 163 patients, 55 cases got good recoveries, 47 cases got moderate disabilities, 13 cases suffered from severe disability, 16 patients became plant survival, and 32 cases died. Here, good recovery and moderate disabilities are kept in better prognosis group, and worse prognosis group includes severe disability, plant survival, and death. The ICP of better prognosis group at admission was 21.98±8.74 mmHg, which was significantly lower than that of worse prognosis group being 34.17±16.38 mmHg (p＜0.001). As well, the ICP on the third day after injury or operations were respectively 16.84±5.44 mmHg and 31.07±19.79 mmHg for better prognosis group and worse prognosis group; moreover, the difference between them was significant (p＜0.001). The PI of better prognosis group at admission was 1.52±0.42, and it was 1.66±0.69 for worse prognosis group at admission, without statistics difference between them (p＞0.05). As well, the PI 3days after injury or operations were respectively 1.19±0.21 and 1.40±0.90 for better prognosis group and worse prognosis group, and the difference has no statistics significance. However, the PI difference at admission and 3 days after injury or operation were respectively 0.34±0.07 and 0.23±0.09 for better prognosis group and worse prognosis group, with statistics significance (p＜0.05). Conclusion Invasive ICP combined with TCD monitoring has an important clinical guiding role in the treatment of acute traumatic brain injury, and has a predictive effect on the prognosis of traumatic brain injury.