2020•Chin J Neurotrauma Surg(Electronic Edition)Requires access
Influence of intracranial pressure related parameters on the prognosis of patients with traumatic brain injury
Zhizhou Li, Wangming Zhang, Huaqing Li, Tianrong Wang
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Abstract
Objective
To investigate the effect of intracranial pressure on the survival of patients with traumatic brain injury (TBI).
Methods
The clinical data of 62 patients with TBI admitted to Department of Neurosurgery, Xinxing County People’s Hospital from June 2016 to June 2018 were retrospectively analyzed. According to the GOS score of patients at discharge, they were divided into poor prognosis group (death, GOS Ⅰ-Ⅱ n=25) and good prognosis (GOS Ⅲ-Ⅳ, n=37). The intracranial pressure, brain tissue oxygen partial pressure, cerebral perfusion pressure and hemodynamics were compared within 24 h after operation. The correlation between intracranial pressure related parameters and poor prognosis in patients with TBI was analyzed.
Results
The intracranial pressure and cerebral oxygen partial pressure in patients with good prognosis were lower than those in poor prognosis group, and the levels of cerebral perfusion pressure, systolic blood flow velocity (Vs), mean blood flow velocity (Vm) and end diastolic blood flow velocity (Vd) were higher than those in the group with poor prognosis (P<0.05). The intracranial pressure and brain oxygen partial pressure in patients with TBI were positively correlated with poor prognosis (r=0.618, P=0.000; r=0.514, P=0.000). The cerebral perfusion pressure, Vs, Vm and Vd were negatively correlated with poor prognosis (r=-0.571, P=0.000; r=-0.562, P=0.000; r=-0.501, P=0.000; r=-0.575, P=0.000).
Conclusion
Intracranial pressure, cerebral oxygen partial pressure, cerebral perfusion pressure and hemodynamics are related to the prognosis of patients with TBI. Active control of intracranial pressure and cerebral oxygen partial pressure, promotion of cerebral perfusion pressure, close monitoring of hemodynamic indexes, can improve the survival of patients.
Key words:
Traumatic brain injury; Intracranial pressure; Brain tissue oxygen partial pressure; Cerebral perfusion pressure; Hemodynamics