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The effect of emergent pre-operarative skull drilling drainage on severe traumatic cerebral hernia's intracranial pressure,brain tissue partial pressure of oxygen and its prognosis
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.1008-6706.2006.02.002
- Key Word:
- 脑损伤;脑疝;钻颅引流;颅内压;脑组织氧分压
Abstract： 目的监测钻颅引流前后颅内压(ICP)、脑组织氧分压(PbtO2),探讨术前急诊钻颅引流在重型颅脑创伤脑疝患者中应用的临床价值.方法按脑创伤脑疝类型分为单瞳散大组42例,双瞳散大组34例,均在开颅前行急诊钻颅引流术,并同时在非损伤侧额叶脑组织内先置入ICP、PbtO2探头,连续监测并记录钻颅引流前后的ICP、PbtO2.结果钻颅引流能降低ICP,提高PbtO2,两组与术前比较差异均有非常显著意义(P＜0.001).治疗结果:良好/中残,单瞳散大组36例(78.57%),双瞳散大组16例(44.12%);重残/长期昏迷:单瞳散大组1例(7.14%),双瞳散大组8例(26.47%);死亡:单瞳散大组7例(14.29%),双瞳散大组15例(44.12%).结论术前急诊钻颅引流术能有效降低ICP和提高PbtO2,改善脑疝症状,缩短脑疝时限,延长脑创伤脑疝患者的手术治疗时间窗,对于提高重型颅脑创伤脑疝患者的治愈率,降低死亡率和致残率,具有较高的临床应用价值.
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