目的

探讨持续颅内压监测在额叶挫裂伤患者治疗中的作用及体会。

方法

选取于山东大学第二医院神经外科自2011年4月至2014年10月收治的额叶挫裂伤患者，对13例额叶脑挫裂伤患者的临床资料进行回顾性研究。所有患者均进行保守或手术治疗，并行持续颅内压监测，采用格拉斯哥恢复评分(GOS)评估预后。

结果

4例患者平稳渡过水肿高峰期，康复出院；9例患者接受脑挫裂伤清除术+去骨瓣减压术。所有患者均随访6个月，恢复良好的为7例，轻度残疾的为1例，重度残疾的为3例，死亡患者为2例。

结论

颅内压监测可为患者争取安全的保守治疗；一旦病情变化，可以及时发现，争取最佳手术时机，改善患者预后。

Objective

To investigate the experience of continuous intracranial pressure monitoring in the treatment of patient with frontal lobe contusions.

Methods

The patients were selected from April 2011 to October 2014 in the Second Hospital of Shandong University treated as brain contusion in frontal lobe. The clinical data of 13 patients with frontal lobe contusions were retrospectively analyzed. All patients accepted conservative treatment or operation treatment, and continuous intracranial pressure (ICP) monitoring, the prognosis of the patients were evaluated by Glasgow Outcome Scale.

Results

Four patients passed the brain edema peak period and recovered completely. Nine patients accepted removal of contusion operation and decompressive craniectomy.All patients were followed-up for 6 months. seven patients obtained good recovery (53.8%), 1 patient was mild disability (7.7%), 3 patients were severe disability (23.1%), and 2 patients died (15.4%).

Conclusions

The disease course of frontal lobe contusions had the characteristics of better conscious condition, abrupt deterioration, and prolonged brain edema duration. The intracranial pressure monitoring could insure the security of conservative treatment, and once the condition deteriorated, it could detect the brain herniation in advance, so the decompressive craniotomy would be carried out accordingly, the patient could havea better outcome.