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严重的创伤性脑损伤需要监测颅压吗?
原作者: Haney Mallemat,肖锋译 文章来源: 中华急诊医学杂志编辑部 发布日期:2013-03-04

Title: Do Monitors Matter?

题目:需要监测(脑压)吗?

Author 作者: Haney Mallemat

Management of patients with severe traumatic brain injury (TBI) typically involves the use of invasive intra-parenchymal pressure monitors. Although use of these monitors is recommended by TBI management guidelines, good quality evidence of benefit is lacking.

严重的创伤性脑损伤(TBI)通常要使用侵入性脑内压力监测。虽然这些监测是在TBI处理指南中建议的,但并没有足够有力的支持证据。

A recently published study evaluated the outcomes of TBI patients using a management protocol incorporating either an intracranial pressure (ICP) monitor compared to use of the clinical exam PLUS serial neuroimaging; a total of 324 patients were prospectively randomized into either group.

一个最新发表的文章对TBI病人在用颅内压监测和用临床检查包括系列脑影像方案的预后进行了评价;一共有324病人被前瞻性地随机分到了任何一组。

The primary study outcome was a composite of survival, impaired consciousness, and functional status at both three and six months.

主要的研究指标包括在3和6个月时的生存率,神志障碍,和功能状态。

The results of the study did not show a significant difference in the:

研究结果显示,在如下几个方面没有明显差别:

• Primary outcome 主要预后指标

• Median length of ICU stay 平均ICU住院时间

• Distribution of serious adverse events 严重的恶性事件的发生

Bottom line: This study suggests that clinical exam PLUS serial neuroimaging may perform as well as invasive intra-parenchymal monitors for guiding therapy in TBI patients.

要点:这个研究显示,在指导TBI病人的治疗上,临床检查加上系列神经影像与侵入性脑内压监测有同样的作用。

References 参考文献

Chestnut, R. et al. A Trial of Intracranial-Pressure Monitoring in Traumatic Brain Injury. NEJM 2012 Dec 12.

文章来源:中华急诊医学杂志编辑部