Evaluation of intracranial pressure monitoring and cerebral perfusion pressure in the treatment of diffuse axonal injury

LIN Hui; CAI Zhi-ji; DING Zhi-jun

doi:10.3969/j.issn.1009-4237.2017.12.006

Abstract：Objective To investigate the clinical value of the continuous dynamic monitoring of intracranial pressure and cerebral perfusion pressure in the treatment of diffuse axonal injury .Methods Totally 45 cases ( GCS 3-5) of diffuse axonal injury hospitalized in our department and intensive care unit from Jan .2012 to Apr.2016 were collected and randomly divided into the monitoring group and control group .Twenty-two patients in the monito-ring group received intracranial pressure monitoring ,and the intracranial pressure was controlled based on the moni-toring results,and 23 patients in the control group had no intracranial pressure monitoring .The prognosis,dose of mannitol and the incidence rate of delayed intracranial hematoma and cerebral infarction were compared between the two groups.Results The incidence of death and plant survival in the monitoring group was 9.10%,less than those of the control group ( 39.13%) with statistical significance ( P<0.05 ) , and the prognosis in the monitoring group was better than that in the control group .The dose of mannitol in the monitoring group (628.64g) was less than that of the control group(1208.70g) with significant difference(P<0.05).About delayed intracranial hematoma and cerebral infarction,there was no significant difference between the two groups (P>0.05).Conclusion Continuous dynamic monitoring of intracranial pressure and cerebral perfusion pressure can detect the changes of pressure timely in the treatment of diffuse axonal injury ,and then the appropriate treatment measures could be taken to improve the outcomes of patients .