2012•China Modern MedicineRequires access
Clinical studies of large decompressive craniectomy to improve cerebral blood flow and brain metabolism in patients with severe brain injury
Heli Lv
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Abstract
Objective: To investigate the effect of large decompressive craniectomy on cerebral blood flow and brain metabolism in patients with severe traumatic brain injury. Methods: Sixty patients with severe brain injury in our hospital from May 2007 to June 2010 were selected as reasch objects of which 38 cases were treated with hemicraniectomy treatment (observation group), 22 patients were given medicine therapy (control group), All patients were given minimally invasive cranial drill to monitor intracranial pressure (ICP), the left radial vein puncture to monitor mean arterial pressure (MAP), heart rate (HR), and made blood gas analysis of the radial artery, internal jugular venous, including blood glucose, blood lactate, oxygen saturation, blood oxygen pressure, hemoglobin. to measure cerebral perfusion pressure (CCP = MAP-ICP), jugular vein-the radial artery lactate, cerebral oxygen uptake rate before treatment and 1, 3, 6 days after treatment, compared indicators of two groups. Results: 1, 3, 6 days after treatment, cerebral oxygen uptake rate of patients ≤ 50-year-old of observation group was significantly higher than control group(P0.05), cerebral oxygen uptake rate of patients 50-year-old was lower than control group (P0.05); 3, 6 days after treatment, the jugular vein-arterial lactate of ≤ patients 50-year-old of observation group was significantly lower than the control group(P0.05), jugular vein-arterial lactate of patients 50-year-old was higher than the control group; intracranial pressure of observation group was lower than control group, cerebral perfusion pressure was higher than control group. Conclusion: Hemicraniectomy can effectively reduce intracranial pressure in patients with severe traumatic brain injury, improve cerebral perfusion pressure, and it can significantly improve cerebral oxygen uptake rate of patients ≤ 50-year-old, but reduce cerebral oxygen uptake rate of patients50-year-old.