关键词 弥漫性轴索损伤；颅内压；预后

    摘要 目的 观察重型弥漫性轴索损伤颅内压的变化，探讨持续动态颅内压监测在重型弥漫性轴索损伤治疗中的临床应用价值。方法 选择78例重型弥漫性轴索损伤患者(GCS<8分)，随机分为二组，颅内压监测组(ICP组)入院后即行侧脑室内穿刺置管颅内压监测，根据颅内压的变化随时调整治疗方案，对照组入院后不做颅内压监测，根据患者的意识和生命体征变化，进行常规治疗。结果 ICP组在脱水剂应用时间、剂量及并发症方面均低于对照组，二组差异有统计学意义(P<0.01)；ICP组预后优于对照组(P<0.01)。结论 重型弥漫性轴索损伤患者早期行持续颅内压监测对尽早发现病情变化，及时采取有效治疗措施，降低并发症、病死率及病残率，改善预后有重要意义。

    CLINICAL SIGNIFICANCE OF SUCCESSIVE INTRACRANIAL PRESSURE MONITORING OF SEVERE DIFFUSE AXONAL INJURY

    Zhang Keli，Wang Lianyou. Department of neurosurgery, Baodi hospital, Tianjin 301800,China

    Key words diffuse axonal injury；intracranial pressure；prognosis

    Abstract Objective To discuss the clinically applicative value of successive intracranial pressure(ICP) monitoring by observing variety of intracranial pressure of severe diffuse axonal injury(DAI). Methods 78 patients with severe DAI were divided into ICP group and control group at random.Patients in ICP group were given successive ICP monitoring via early intubation into the ventricle, and their therapeutic schemes were adjusted on the basis of ICP fluctuation; as for therapy in control group ......