Application value of invasive intracranial pressure targeted management in sTBI patients during perioperative period

doi:10.3877/cma.j.issn.2095-9141.2022.05.008

Abstract

Abstract:

Objective

To explore the value of targeted management of invasive intracranial pressure (ICP) monitoring during the perioperative period in patients with severe traumatic brain injury (sTBI).

Methods

A retrospective cohort study was used to select the clinical data of 168 sTBI patients admitted to the Neurosurgery Diagnosis and Treatment Center of Qianfoshan Hospital from January 2017 to December 2021. The sTBI patients monitored by ICP were set as the experimental group (88 cases), and the sTBI patients not monitored by ICP at the same time were set as the control group (80 cases). The application of mannitol, postoperative complications, GOS score at discharge, hospitalization cost, hospitalization time and neurosurgical intensive care unit (NSICU) treatment duration of the two groups were compared and analyzed.

Results

Compared with the control group, the duration and total amount of mannitol in the experimental group were significantly reduced, and the duration of hospitalization and NICU treatment were significantly reduced, while the good prognosis rate was higher, with statistically significant differences (P<0.05); There was no significant difference in intracranial infection rate and unplanned reoperation rate between the two groups (P>0.05).

Conclusion

Targeted control under invasive ICP monitoring will have more benefits in dynamically monitoring the changes of ICP, assessing the state of illness in time, controlling the use of mannitol effectively, improving the prognosis of the patients, lowering the length of stay, and reducing the rate of intracranial infection for sTBI patients.

Key words: Severe traumatic brain injury, Intracranial pressure monitoring, Perioperative period, Mannitol, GOS score, Targeted management

Fuyi Zhang, Xianzeng Hou, Jianjun Wang, Tao Xin. Application value of invasive intracranial pressure targeted management in sTBI patients during perioperative period[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(05): 298-301.

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References 23

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组别	例数	性别（男/女）	年龄（±s）	入院时GCS评分（分，±s）	发病距入院时间[h，M（P₂₅，P₇₅）]	手术距入院时间[min，M（P₂₅，P₇₅）]
试验组	88	63/25	52.75±12.03	5.33±1.94	3.00（2.00，6.75）	120.00（83.50，162.25）
对照组	80	65/15	53.73±15.60	5.39±1.91	3.00（2.00，5.00）	91.50（46.25，120.00）
t/χ²/Z值		2.155	0.456	0.195	0.936	1.937
P值		0.142	0.649	0.846	0.349	0.053

组别	例数	性别（男/女）	年龄（±s）	入院时GCS评分（分，±s）	发病距入院时间[h，M（P₂₅，P₇₅）]	手术距入院时间[min，M（P₂₅，P₇₅）]
试验组	88	63/25	52.75±12.03	5.33±1.94	3.00（2.00，6.75）	120.00（83.50，162.25）
对照组	80	65/15	53.73±15.60	5.39±1.91	3.00（2.00，5.00）	91.50（46.25，120.00）
t/χ²/Z值		2.155	0.456	0.195	0.936	1.937
P值		0.142	0.649	0.846	0.349	0.053

组别	例数	甘露醇使用天数（d）	甘露醇应用总量（mL）
试验组	88	5.00（2.00，7.00）	1900.00（825.00，2837.50）
对照组	80	7.00（3.00，10.75）	2312.50（600.00，4500.00）
Z值		2.599	2.022
P值		0.009	0.043

组别	例数	甘露醇使用天数（d）	甘露醇应用总量（mL）
试验组	88	5.00（2.00，7.00）	1900.00（825.00，2837.50）
对照组	80	7.00（3.00，10.75）	2312.50（600.00，4500.00）
Z值		2.599	2.022
P值		0.009	0.043

组别	例数	颅内感染率	再次手术率
试验组	88	10（11.36）	9（10.22）
对照组	80	16（20.00）	11（13.75）
χ²值		2.839	1.876
P值		0.122	0.171

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