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Objective To explore the optimal duration of long-term mild hypothermia (MHT) for traumatic brain injury (TBI) in rats, and observe its effect on intracranial pressure (ICP) and neurological function. Methods Forty-eight healthy adult male SD rats were divided into the normal temperature treatment (NT) group, the MHT4 h group, the MHT24 h group and the MHT48 h group by random number table method, with twelve rats in each group. The TBI model of rats was prepared by electronic controllable cortical injury device, and ICP monitoring probe was implanted. After modeling, the NT group was treated with normal temperature (37 ℃), and the other groups were treated with low temperature (33.0±1.0 ) ℃ for 4 h, 24 h and 48 h, respectively. ICP was monitored and brain water content (BWC) was calculated after MHT treatment in each group. Blood-brain barrier permeability was determined by Evansland (EB) staining. The expression of 5-bromodeoxyuracil nucleoside (BrdU), neuronal nuclear antigen antibody (NeuN) and leukocyte differentiation antigen 86 (CD86) positive cells were detected by immunofluorescence staining. The expressions of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), inducable nitric oxide synthase (iNOS), interleukin (IL) -10 and arginase 1 (Arg-1) were detected by Western blot assay. Results Compared with the NT group, levels of BWC, ICP, EB, and CD86 positive cells, Bax and iNOS expression levels were decreased in the MHT4 h group, the MHT24 h group and the MHT48 h group, and the number of BrdU positive cells and BrdU/NeuN double-labeled positive cells were increased in hippocampus. The expression levels of Bcl-2, IL-10 and Arg-1 were increased (P＜0.01). Compared with the MHT24 h group, levels of BWC, ICP and EB, and CD86 positive cells, Bax and iNOS expression were decreased, and the number of BrdU positive cells and BrdU/NeuN double-labeled positive cells were increased in the MHT48 h group, while levels of Bcl-2, IL-10 and Arg-1 expression were increased (P＜ 0.01). Conclusion Long-term MHT can promote the proliferation and differentiation of neurons, inhibit apoptosis and reduce inflammation by suppressing ICP rebound, further promoting neuroprotection after TBI. [ABSTRACT FROM AUTHOR]

Objective：To establish an effective method for predicting intracranial pressure (ICP) by measuring optic sheath diameter (ONSD) using ultrasonography. Methods：52 patients with severe neurological conditions were continuously monitored for postoperative invasive ICP. The mean diameter of the optic nerve sheath in vertical and horizontal directions was measured by transorbital ultrasound. The diagnostic efficacy of ONSD in intracranial hypertension was analyzed by receiver operating characteristic (ROC) curve，and the sensitivity and specificity of the method were evaluated. Results：The mean binocular ONSD (5.27±0.47) mm was well correlated with invasive ICP (11.77±6.18) mmHg in all patients (r=0.79，P < 0.01) . ROC curve showed that the ONSD cutoff for detecting intracranial hypertension (ICP≥20 mmHg) was 5.625 mm，with a sensitivity of 74.3% and a specificity of 90.4% . Meanwhile，the ONSD cutoff corresponding to ICP 5，10，15 and 25 mmHg were 5.175，5.325，5.375 and 5.825 mm. Conclusions： Bedside ultrasound measurements of ONSD through orbit can determine changes of ICP，especially in the case of invasive ICP or limited imaging examinatior in patients with severe neurological conditions . The ICP can be evaluated dynamically，quickly and non⁃ invasively，which has significant clinical application value and is worthy of promotion [ABSTRACT FROM AUTHOR]

Objective To investigate the influence of different sedation depth guided by the bispectral index (BIS) on the therapeutic effects for severe traumatic brain injury (TBI). Methods Totally 37 patients with severe traumatic brain injury (sTBI) admitted to Department of Neurosurgery, the Affiliated Jiangyin Hospital from October 2015 to December 2016 were included and divided into Richmond agitation sedation scale (RASS), BIS (Ⅰ) and BIS (Ⅱ) groups. RASS group was controlled the level of sedation to within-2 or-3, and the BIS (Ⅰ) and (Ⅱ) groups within the range of 40 to 50 and 50 to 60, respectively. RASS, BIS and intracranial pressure (ICP) values were collected, in addition to clinical data. RASS and ICP variability were introduced to investigate the different of sedative control effect with or without BIS monitor, and the control effect of ICP between different sedation levels. Statistical analysis was performed to estimate the effectiveness of different sedation levels guided by BIS in sedation treatment within 72 hours. Results There were no significant differences in demographics among three groups (P＞0.05). RASS variability of BIS (Ⅰ) and (Ⅱ) groups were significant lower than RASS group’s (P＜0.05), and BIS (Ⅰ) group were insignificantly lower than BIS (Ⅱ) group. ICP of BIS (Ⅰ) and (Ⅱ) groups declined to below 13.5 mmHg significantly earlier than RASS group’s (P＜0.05), and difference between BIS (Ⅰ) and (Ⅱ) was insignificant. ICP variability of RASS group was higher than those of BIS (Ⅰ) and (Ⅱ) groups (P＜0.05), and ICP variability of BIS (Ⅰ) group was significantly lower than BIS (Ⅱ) group (P＜0.05). Differences in NICU stay and outcomes among three groups were insignificant. Conclusions BIS is more reliable than RASS for maintaining a stable sedation status and ICP. Deeper sedation levels (BIS 40-50) cause ICP to drop more quickly with lower ICP variability. [ABSTRACT FROM AUTHOR]

This paper summarized the rehabilitation nursing management of a patient with severe traumatic brain injury complicated with multiple rupture of thoracic-abdominal organs based on the concept of enhanced recovery after surgery. Based on the enhanced recovery after surgery, a multidisciplinary team for rehabilitation management was set up. Comprehensive treatment and nursing interventions including postoperative management of intracranial pressure, management of traumatic liver injuries, exercise rehabilitation, postoperative thromboembolism prevention, enteral nutrition support and management of antiepileptic drug were carried out to prevent postoperative complications and improve the rehabilitation. (本文总结1例基于加速康复外科(ERAS)理念的重型颅脑创伤伴肝脾破裂、肋骨骨折、肺、肾挫裂伤危重症患者的康复护理经验。基于ERAS理念, 组建多学科康复管理团队, 制定全面的康复治疗方案, 包括术后颅内压管理、创伤性肝损伤康复、运动康复管理、术后血栓预防管理、术后肠内营养管理、术后抗癫痫等详细的康复方案, 有效预防相关并发症, 促进患者康复。)

Objective To investigate the predictive value of the ratio of ultrasonic optic nerve sheath diameter to eyeball transverse diameter (ONSD/ETD) for intracranial pressure (ICP) in patients with traumatic brain injury (TBI) and its correlation analysis. Methods 90 TBI patients according to the ICP results measured by lateral ventriculectomy were divided into ICP elevated group (ICP＞200 mmH2O, n=32) and ICP normal group (ICP≤200 mmH2O, n=58), while 90 TBI patients according to Glasgow Outcome Scale (GOS) were included in the good prognosis group (the patients with 4-5 scores, n=38) and in the poor prognosis group (the patients with 1-3 scores, n=52). The differences of ICP, ONSD, ETD and ONSD/ETD were compared between the two groups. GCS scores, ICP, ONSD, ETD and ONSD/ETD were compared between the two groups. The correlation between ONSD, ONSD/ETD under ultrasound and ICP was analyzed by Spearman correlation analysis, where the receiver operator characteristic curve (ROC) was used to compare the accuracy of ONSD and ONSD/ETD under ultrasound in predicting ICP rise. Results On the 1st, 3rd and 7th day after operation, the GCS score of the two groups increased gradually, and the GCS score of the ICP elevated group was lower than that of the ICP normal group, where the comparison between the two groups and within the group was statistically significant (P ＜ 0. 05). The levels of ICP, ONSD and ONSD/ETD ratio of the two groups decreased gradually and the level of ICP increased group was higher than that of ICP normal group, where the comparison between groups and within groups was statistically significant (P ＜ 0. 05). The GCS score of poor prognosis group was lower than that of good prognosis group, while ICP, ONSD and ONSD/ETD under ultrasound in poor prognosis group were higher than those in good prognosis group (P ＜ 0. 05). Spearman correlation analysis showed that there were a positive correlation between ONSD, ONSD/ETD under ultrasound and ICP (r = 0. 593 and 0. 621, P ＜ 0. 001). The ROC curve showed that the area under the curve of ONSD and ONSD/ETD under ultrasound were 0. 884 and 0. 923, the sensitivity were82. 50% and 90. 0%, the specificity were 80. 00% and 83. 50%, and the best threshold were 5. 15mm and 0. 25, respectively. Kappa consistency test showed that the predictive effect of ONSD and ONSD/ETD under ultrasound on ICP elevation was consistent with that of intraventricular pressure measurement (Kappa = 0. 612 and 0. 725, P ＜ 0. 05), and the predictive effect of ONSD and ONSD/ETD under ultrasound was consistent (Kappa = 0. 812, P ＜ 0. 001). Conclusion ONSD/ETD under ultrasound is better than ONSD under ultrasound in predicting ICP elevation, with high sensitivity and specificity, which has clinical application prospect. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical value of intracranial pressure, intracranial temperature, serum D-dimer (D-D) and albumin in predicting the postoperative short-term prognosis of patients with severe traumatic brain injury (STBI). 124 patients with STBI who were admitted to our hospital from March 2020 to January 2022 were selected. All patients were treated with craniocerebral surgery. 3 months after operation, according to the difference of Glasgow Outcome Scale (GOS) score, they were divided into 43 cases in the poor prognosis group (GOS score 臆3 scores) and 81 cases in the good prognosis group (GOS score >3 scores). The postoperative intracranial pressure, intracranial temperature, serum D-D and albumin levels at admission were recorded. The influencing factors of poor short-term prognosis in patients with STBI were analyzed by multivariate Logistic regression model. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of intracranial pressure, intracranial temperature, serum D-D and albumin levels in predicting the poor short-term prognosis of patients with STBI. The postoperative intracranial pressure and serum D-D level at admission in the poor prognosis group were higher than those in the good prognosis group, and the postoperative intracranial temperature and serum albumin level at admission in the poor prognosis group were lower than those in the good prognosis group (all P＜0.05). The age in the poor prognosis group was older than that in the good prognosis group, the Glasgow Coma Scale (GCS) score at admission was lower than that in the good prognosis group, and the incidence of multiple injury, brain hernia, hypernatremia and brain stem injury was higher than that of the good prognosis group (all P＜0.05). Multivariate Logistic regression analysis showed that postoperative intracranial pressure (higher) and serum D-D level at admission (higher) were risk factors for poor short-term prognosis of patients with STBI (P＜0.05), and postoperative intracranial temperature (higher) and serum albumin level at admission (higher) were protective factors for poor short-term prognosis of patients with STBI (P＜0.05). ROC curve analysis showed that the area under the curve (AUC), sensitivity and specificity of the combined detection of intracranial pressure, intracranialtemperature, serum D-D and albumin levels in predicting the poor postoperative short-term prognosis of patients with STBI were higher than those of the above four indicators. Postoperative intracranial pressure, intracranial temperature, serum D-D and albumin levels at admission are the influencing factors for the postoperative short-term prognosis of patients with STBI. The combination of the above four indicators is of high value in predicting the poor short-term prognosis of patients with STBI after surgical treatment. [ABSTRACT FROM AUTHOR]

Intracranial hypertension is mainly caused by brain edema induced by different diseases, the key points of the treatment of brain edema is to pump water from the brain tissue into the intravascular space to reduce intracranial pressure by dehydrating agents, that is osmotic pressure therapy, and the most common used dehydrating agents are mannitol and hypertonic saline. Researches suggest that hypertonic saline may have more profound and long-lasting effect in reducing intracranial hypertension compared with mannitol. Therefore, the hypertonic saline has been widely used in the treatment of clinical cerebral edema in recent years, mainly by its mechanism of altering osmolarity, improving blood rheology, circulatory system and immune regulatory. However, there are inconsistencies in the dose, frequency, concentration and administration route of hypertonic saline. This paper reviews the treatment of intracranial hypertension with hypertonic saline. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the feasibility of ultrasonic measurement of optic nerve sheath diameter (ONSD) in the treatment of dehydration of intracranial hypertension (ICH) in patients undergoing glioma surgery. Methods: A total of 40 patients with cranial hypertension who underwent elective frontal glioma resection were randomly divided into 2 groups (n = 20). After 10 minutes of endotracheal intubation, Group M was given 20% mannitol 0.5 g/kg intravenously within 15 minute; Group C was given the same amount of normal saline intravenously within 15 minutes. ONSD values of both eyes were measured before anesthesia induction (T0), immediately after endotracheal intubation (T1), at the beginning of drug infusion (T2), 30 min after drug infusion (T3), immediately after surgery (T4), and 24 h after surgery (T5). The levels of VEGF-A, MMP-9 and ET-1 in serum at each time were detected. Cerebral relaxation score ( BRS) was recorded when the dura was opened. Results: At T3, T4 and T5, the ONSD value and serum concentrations of VEGF-A, MMP-9 and ET-1 in group M were significantly lower than those in group C (P < 0.05). BRS score in M group was significantly lower than that in C group (P < 0.05). Conclusion　For glioma patients with intracranial hypertension before operation, dehydration treatment in advance under the guidance of optic nerve sheath diameter can effectively reduce cerebral edema. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of static pushing speed of mannitol on the intracranial pressure. Methods Totally 70 children with acute intracranial pressure increase were divided into two groups: 35 cases in the control group received routine rate of mannitol injection and 35 cases in the observation group received the slow first and then fast injection of mannitol. The effect of two mannitol injection rates was compared. Results The effective time to response of intracranial pressure reduction in the observation group was slightly longer than that in the control group , but with no significant difference(P > 0. 05). The duration of effective intracranial pressure in the observation group was longer than that in the control group (P < 0. 05), and the incidence of adverse reactions in the observation group was lower than that in the control group (P < 0. 05). Conclusion The fast first and then slow injection of mannitol is helpful to maintain the stability of intracranial pressure and reduce the incidence of adverse reactions caused by the drug. (目的 探讨甘露醇静脉推注对颅内压的影响。方法 采用随机数字表法将70例急性颅内压增高症患儿分为2组, 各30例。对照组患儿静脉注射甘露醇时采用常规推注速度, 观察组采取先慢后快的静脉推注速度, 对比2组应用效果。结果 观察组颅内压降低显效时间长于对照组, 但差异无统计学意义(P＞0. 05)。观察组有效颅内压持续时间长于对照组, 差异有统计学意义(P＜0. 05); 观察组不良反应发生率较对照组低, 差异有统计学意义(P＜0. 05)。结论 采取先慢后快的静脉推注速度更有助于维持颅内压的平稳, 降低由该药物所致的不良反应发生风险。)

Objective To explore the clinical value of dynamic intracranial pressure (ICP) monitoring combined with regional cerebral oxygen saturation (rSc02) monitoring target oriented therapy for severe traumatic brain injury (sTBI). Methods 60 patients with sTBI were randomly divided into dynamic ICP monitoring combined with rSc02 monitoring target oriented treatment group (combined monitoring group) and control group, with 30 cases in each group. The patients in the control group were treated under neurosurgical intensive care. The patients in the combined monitoring group were guided by ICP combined with rSc02 target monitoring on the basis of traditional intensive care treatment in neurosurgery. Results The Glasgow coma scale(GCS) score of patients in the combined monitoring group was higher than that in the control group. The GCS score of patients in the two groups was higher than that in the admission group, but the difference was not statistically significant (all P > 0. 05). The length of total hospital stay and the length of stay in neurosurgical intensive care unit (NSICU) in the combined monitoring group were significantly lower than those in the control group (P<0.05~0.01). At 6 months after discharge, the scores of modified Rankin Scale (mRS) and Glasgow prognosis scale (GOS) in the combined monitoring group were significantly better than those in the control group (P<0.05~0.01), and the mortality was significantly lower than that in the control group (P < 0. 05). Kaplan-Meier survival curve analysis showed that the survival time of patients in the combined monitoring group was significantly better than that in the control group (P < 0. 05). Conclusion ICP combined with rSc02 monitoring target oriented treatment can effectively shorten the total hospital stay and NSICU stay of sTBI patients, reduce the mortality and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

目的 了解颅内静脉窦狭窄（cerebral venous sinus stenosis，CVSS）患者眼部特征，分析静脉窦支架置 入术后眼底改变情况，探讨与视盘水肿程度相关的可能因素。 方法 回顾性纳入2014年1月-2018年8月在首都医科大学附属北京天坛医院神经介入中心确诊，并 行静脉窦支架置入术的CVSS患者，收集患者一般资料、病程、视力、眼底检查、视野情况、颅内压、 DSA检查、静脉窦内压测定及患者术后的眼部变化等临床资料。总结CVSS患者的眼部特征和静脉窦 支架置入术后的眼底改变情况，应用Kendall’s tau-b相关分析探讨与视盘水肿程度相关的可能因素。 结果 共纳入125例CVSS患者，存在视功能损害者101例（80.8%），包括视物模糊、视力下降、视 物变形、阵发性黑蒙、视野缺损、复视等，其中65例（52.0%）眼部症状为首发症状，35例（28.0%）仅 表现出眼部症状。视盘水肿115例，共223只眼。视盘水肿等级中位值3（2～4）级（Fri sén分级）。部分 患者可见视盘周围出血、渗出、棉绒斑，视网膜皱褶及静脉迂曲扩张，视盘色淡或苍白等。视盘水 肿等级与颅内压正相关（Kendall’s tau-b=0.271，P =0.029），与病程负相关（Kendall’s tau-b=-0.261， P =0.002）。其中79例经内科治疗无效患者接受了静脉窦支架置入术，术后患者视盘水肿均有减轻， 术后1个月视盘水肿等级降为2（1～3）级；术后6个月时视盘水肿完全消退比例达94.4%（135/143）。 结论 对双眼视盘水肿患者要除外CVSS可能性；眼底检查是CVSS诊疗评估及判断颅内压情况的 一项重要无创检查，同时也是CVSS患者治疗后随访观察的必要检查。视盘水肿程度与颅内压正相关， 与病程负相关；静脉窦狭窄合并视盘水肿经内科治疗无效患者可考虑行静脉窦支架置入术治疗，促 进视盘水肿消退，减少视神经不可逆性损害。 Abstract: Objective To understand ocular manifestations of patients with cerebral venous sinus stenosis (CVSS), analyze fundus changes after venous sinus stenting and explore possible related factors of papilledema degree. Methods Data of patients with CVSS in Neurointervention Center, Beijng Tian Tan Hospital from January 2014 to August 2018 were retrospectively analyzed. The ocular characteristics of CVSS patients and ophthalmological changes after CVSS stenting were analyzed and summarized. Results Of 125 patients, 101 (80.8%) had visual impairment, including blurred vision or decreased vision, metamorphosis, transient amaurosis, visual field defect, diplopia. 65 (52.0%) patients had ocular discomfort as the first symptom and 35 (28.0%) patients had only ocular symptom. Of 115 patients (223 eyes) with initial papilledema, the median pepilledema grade was 3 (2-4) (Frisén grades). Some patients showed hemorrhage, exudation, cotton-wool spot, retinal tissue fold surrounding the disc, dilated and tortuous retinal veins, papilla pale. There was a positive relevance between papilledema grade and intracranial pressure (Kendall’s tau-b=0.271, P =0.029), and a negative relevance between papilledema grade and duration of the disease (Kendall’s tau-b=-0.261, P =0.002). 79 patients underwent venous sinus stenting, papilledema of all patients with stenting alleviated soon after operation. At 1 month after stenting, the grade of papilledema was reduced to grade 2 (1-3). At 6 months after stenting, 94.4% eyes (135/143) with initial papilledema had no edema in the disc. Conclusions Patients with binocular papilledema should consider CVSS. The fundus examination is necessary for diagnosis and follow up of CVSS and assessing intracranial pressure. Papilledema degree had a positive relevance with intracranial pressure, and a negative relevance with duration of the disease. Patients with CVSS and papilledema who are refractory for medical treatment should consider venous sinus stenting as possible as earlier to reduce papilledema and irreversible damage of optic nerve.

Published reports have suggested that patients previously shunted for hydrocephalus or arachnoid cyst may appear slit ventricle syndrome presenting with intermittent headache and narrow ventricles. At present， the pathogenesis and treatment of slit ventricle syndrome have not been thoroughly studied， which is still a challenge for neurosurgeons. This paper aims to review its etiology， pathophysiology， clinical manifestations， diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective: To analyze the changes of cerebral blood flow and intracranial pressure in patients with hypertensive intracranial tumors during preventive inhalation of sevoflurane. Methods: 80 patients with hypertensive intracranial tumors admitted to our hospital from August 2018 to August 2019 were selected as the research objects, and they were randomly divided into two groups, the control group 40 cases, and propofol was given to maintain anesthesia; the research group Forty patients were given sevoflurane to maintain anesthesia, and the changes in cerebral blood flow and intracranial pressure were observed in the two groups. Results: 1) Comparison of hemodynamic indexes of anteriorcerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) between the two groups, before anesthesia (T0) Resistance Index (RI) and the average velocity (Vm) were not statistically different (P>0.05); induction anesthesia (T1), maintenance anesthesia (T2), end of operation (T3) time point RI Compared with Vm, the study group was significantly better than the control group (P<0.05); 2) There was no significant difference in intracranial pressure (ICP) between the two groups before anesthesia (P>0.05); T1, T2 At T3 time point, the ICP of the two groups of patients was compared, and the study group was significantly lower than the control group (P<0.05). Conclusion: Preventive inhalation of sevoflurane can maintain the stability of cerebral blood flow in patients with hypertensive intracranial tumors, while reducing the intracranial pressure of the patients, making the patients deeply anesthetized, and avoiding some risk events during the operation. The clinical significance is worthy of promotion and application. [ABSTRACT FROM AUTHOR]

Objective: To explore the application effect of neuroelectrophysiology combined with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in intracranial aneurysm clipping. Methods: A total of 60 patients with intracranial aneurysm who underwent craniotomy in our hospital from December 2018 to January 2020 were selected and divided into two groups by a simple randomization method, with 30 cases in each group. The control group performed intracranial aneurysm clipping surgery, and the observation group was based on the control group with intraoperative neuroelectrophysiology, ICP, and CPP monitoring. Comparison of the aneurysm clipping between the two groups, the new neurological deficits on the first day after the operation, the Glasgow Coma Score (GCS) before the operation, 1 day after the operation, and 3 months after the operation, and the National Institutes of Health Stroke Scale ( NIHSS) score and good prognosis rate 3 months after operation. Results: Both groups of aneurysms were completely clipped. The rate of new neurological deficits in the observation group was 6.67% (2/30) on the first day after surgery, which was lower than 26.67% (8/30) in the control group (P<0.05); The GCS score of the observation group was higher than that of the control group on the 1st day, and the NIHSS score was lower than that of the control group (P<0.05); after excluding cases lost to follow-up, the excellent and good rates of GOS classification and mRS classification in the observation group were 88.89% and 88.89%, respectively. Compared with 88.00% and 84.00% of the control group, the difference was not statistically significant (P>0.05). Conclusion: The use of neuroelectrophysiology combined with ICP and CPP monitoring can grasp the blood flow of the brain tissue of patients undergoing intracranial aneurysm clipping in real time. According to the monitoring results, timely corresponding intervention measures can be taken to prevent irreversible cerebral ischemia changes and improve postoperative changes. Early patient's state of consciousness reduces the occurrence of early postoperative neurological deficits. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of dexmedetomidine-esmolol combination therapy on the lactic acid contents, the levels of S100B, intracranial pressure (ICP) and outcome in patients with severe traumatic brain injury undergoing decompression craniectomy. Methods Sixty patients with severe craniocerebral trauma who underwent unilateral craniocerebral decompression from January 2015 to December 2018 were selected as the observation objects. According to the application of postoperative sedative drugs, the patients were divided into two groups: the co-treatment group of esmolol combined with dexmedetomidine (the co-treatment group, n=30) and the control group of dexmedetomidine alone (the control group, n=30). Cerebrospinal fluid (CSF) was collected before treatment and on 1, 3 and 7 d after treatment. The lactic acid contents and the levels of S100B of the CSF were detected. Glasgow coma scale (GCS) score and National Institute of Health stroke scale (NIHSS) score were compared 14 d after treatment between the two groups. Glasgow outcome scale (GOS) score were used to evaluate long-term outcome on 6 months after treatment. Results After treatment, CSF lactic acid content and S100B level decreased significantly at 1, 3 and 7 d after treatment in co-treatment group than those of the control group (P＜0.05). The GCS score and NIHSS score were significantly higher at 14 d after treatment in the cotreatment group than those in the control group (P＜0.01). There was no significant difference in the GOS score within 6- month follow up between the two groups of patients (P＞0.05). Conclusion Dexmedetomidine-esmolol combination therapy can reduce the levels of CSF lactic acid and S100B in patients with severe traumatic brain injury undergoing decompression craniectomy and improve the short-term outcome, but it has no significant effect on the long-term prognosis. [ABSTRACT FROM AUTHOR]

Objective To observe and evaluate the changes of optic nerve sheath diameter (ONSD) in patients with 30 °high head and low body position during laparoscopic gastrectomy. Methods Forty-four patients underwent laparoscopic gastrectomy. After the beginning of pneumoperitoneum, the posture was in the 30 ° high head and low body position, and returned to supine position at the end of the operation. The right eye ONSD was measured by 12M Hz ultrasound probe before pneumoperitoneum (T0)， 15 min after pneumoperitoneum (T1 ), immediately after head elevation (T2), 30 min af ter pneumoperitoneum (T3 ), and 5 min after operation (T4).M ean arterial pressure (MAP), end-expiratory carbon dioxide (PETC 02) and peak airway pressure (Ppeak) were recorded. The correlation between right eye ONSD and sex and body mass index (BMI) was analyzed. Results The ONSD of the right eyeball at T0, T1, T2, T3 and T4 were 4. 8 土1.0, 5.5 土1.1, 5. 7 土0.9, 5.9 土1.0, and 5. 1 土1.2 mm, respectively. C ompared with T0, OSND increased at T1, OSND increased at T2 and T3, and OSND increased at T3 as compared with those at T2 (all P< 0 . 05). TheM AP of 44 patients at T0, T1, T2, T3 and T4 was 83. 36 土0.68, 88.20 土0.67, 84. 32 土0.72, 83. 85 土0.66, 82.85 土0.55, respectively; PET C O2 was 31. 25 土2.81, 33. 17 土2.76, 36.35 土2.68, 36. 85 土1.98, and 32. 83 土2.52, respectively; Ppeak was 16.10 土2.11, 23. 21 土3.13, 26.32 土3.19, 27. 17 土4.11, 16. 15 土2.35, respectively; compared with T0,MAP, PET C O2 and Ppeak increased at T 1 (all P< 0 . 05), P口CO2 and Ppeak increased at T2 and T3 . There was a positive correlation between the broadening of ONSD and BMI in the right eye of the patients. Conclusions Over the course of intraoperative pneumoperitoneum, the ONSD in the right eye of patients with 30 °high head and low body position during laparoscopic gastrectomy becomes wider. The broadening of ONSD in the right eye during operation may be related to the body mass of the patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of intracranial pressure/cerebral perfusion pressure( ICP/CPP) guided treatment strategy in improving the long-term prognosis of patients with poor-grade ruptured intracranial aneurysms. Methods The clinical data of 48 patients with poorgrade ruptured intracranial aneurysms were analyzed retrospectively,23 of which underwent the ICP/CPP guided treatment and 25 cases underwent the conventional treatment. The prognosis at 90 days after the operation, the incidence of delayed cerebral infarction and complications, and mortality of the two groups were contrastively evaluated. Results Compared with the conventional treatment group, the ICP guided treatment group had lower incidence of delayed cerebral infarction and better prognosis in the 90 days follow-up. There was no significant difference in the mortality rate and the incidence of complications between the two groups( P > 0. 05). Conclusion Based on the support of comprehensive neuro intensive care, the ICP/CPP guided treatment strategy can significantly reduce the incidence of delayed cerebral infarction and improve the long-term prognosis of patients with poor-grade ruptured aneurysms, compared with the conventional treatment. [ABSTRACT FROM AUTHOR]

脑水肿是缺血性脑卒中的常见并发症，可影响患者神经功能，甚至形成不可逆的继发性脑损害。影像学 检查、生物电阻抗测量技术、经颅多普勒监测等无创脑水肿监测技术由于无创、安全、便捷等原因在缺血性脑卒中应 用广泛，其可在脑水肿监测、脱水药物疗效评价及预后评价方面发挥重要作用。对缺血性脑卒中患者进行脑水肿监 测，有助于把握患者的病情变化、选择合适的治疗方案以及评价预后。 [ABSTRACT FROM AUTHOR]

Objective:To explore the application value of continuous intracranial pressure (ICP) monitoring in the prognosis of surgical treatment of large area cerebral infarction. Methods: From March 2013 to March 2018, 100 patients with large area cerebral infarction who were treated in our hospital were selected as the study objects. All patients underwent ICP monitoring and vital signs monitoring after decompressive operation. According to the results, they were divided into the low pressure group with 62 patients (2.70kPa≤ ICP<5.30kPa) and the high pressure group with 38 patients (ICP≥ 5.30 kPa). ICP monitoring value was recorded, receiver operating characteristic (ROC) curve was used to analyze the prognosis of the patients, and the patients were followed up within 3 months after the operation to understand the prognosis of the patients' normal activity ability. The correlation between ICP and prognosis was observed. Results: There was no significant difference in gender, age, ventricular tachycardia, premature beat, diabetes, hypertension, stroke, hyperlipidemia, rheumatic heart disease, coronary heart disease, dilated cardiomyopathy, previous myocardial infarction, hypertrophic cardiomyopathy and hyperthyroid heart disease between the two groups (P>0.05). The ICP monitoring value of the patients with good prognosis in the low pressure group was significantly lower than that of the patients with poor prognosis (P<0.05). The ICP monitoring value of the patients with good prognosis in the high pressure group was significantly lower than that of the patients with poor prognosis (P<0.05). The area of ROC curve predicted by ICP was 0.704. Calculated the maximum area of AUC predicted by ICP for surgical treatment of massive cerebral infarction by using the most approximate index, and the corresponding cut-off value of the parameter was 4.89, sensitivity was 0.435, specificity was 0.896. Conclusion: The results of continuous ICP monitoring showed that the smaller the ICP value, the better the prognosis of the patients. The higher the ICP value, the worse the prognosis of the patients. ICP monitoring has a predictive value for the prognosis of surgical treatment of large scale cerebral infarction, and it can play an effective role in judging and improving the prognosis, which is worth popularizing in clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of continuous lumbar cistern drainage on intracranial pressure, complications and prognosis in elderly patients with severe craniocerebral injury. Methods: 60 elderly patients with severe craniocerebral injury admitted in First Affiliated Hospital of Chengdu Medical College from August 2014 to August 2018 were selected as the study subjects. The patients were divided into control group(n=30) and research group(n=30) according to random number table method. The control group was given routine dehydration symptomatic treatment after operation, and the research group was given continuous lumbar cistern drainage on this basis. The clinical efficacy and complications were compared between the two groups, and Intracranial pressure at 3 d, 5 d and 7 d after operation. Follow-up for half a year to observe the prognosis of two groups of patients. Results: The total effective rate of the study group was 90.00% after treatment, which was significantly higher than that 66.67% of the control group(P<0.05). The intracranial pressure of the two groups decreased 3 d, 5 d and 7 d after operation and the study group was lower than control group(P<0.05). The incidence of cerebral infarction, cerebral edema, subdural effusion, epilepsy and longitudinal fissure effusion in the study group was lower than that in the control group(P<0.05), but there was no significant difference in intracranial infection(P>0.05). The number of good cases in the study group was higher than that in the control group, while the number of severe disabilities and deaths in the study group was lower than that in the control group(P <0.05), but there was no significant difference in the number of mild disabilities and plant survival between the two groups(P>0.05). Conclusion: Continuous lumbar cistern drainage is effective in the treatment of elderly patients with severe craniocerebral injury. It can significantly improve the intracranial pressure, reduce the incidence of complications and improve the prognosis of patients. It is suitable for clinical promotion. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the effects of intracranial pressure (ICP) monitoring on short-term prognosis and acute kidney injury (AKI) in traumatic brain injury (TBI). Methods Data of 351 patients with TBI in department of neurosurgery of Tianjin Medical University General Hospital were retrospectively studied including 101 patients with ICP monitoring and 250 TBI patients without ICP monitoring. Data of the short-term prognosis, ventilator use time, intensive care unit (ICU) stay, hospitalization time, length of hospital stay, total 20% mannitol usage, the incidence of AKI, the total use of 20% mannitol and the difference of clinical biochemical test results were retrospectively analyzed. The patients were further divided into the medium (n=160) and the severe TBI (n=189) subgroups for analysis of some clinical features. Results There were lower incidence rates of AKI, total 20% mannitol usage, levels of hemoglobin and total protein and albumin in ICP monitoring group than those of no ICP monitoring group (P＜0.005). And there were longer mechanical ventilation days and ICU stay in ICP monitoring group compared to those of no ICP monitoring group (P＜0.005). There were no significant differences in short-term prognostic improvement rate, hospitalization time, globulin, creatinine and urea nitrogen levels between the two groups. In TBI subgroup, the incidence of AKI was significantly lower in ICP monitoring group (n=55) than that of no ICP monitoring group (n=134), but the time of ventilator use and urea nitrogen level were higher in ICP monitoring group than those of no ICP monitoring group (P＜0.05). In medium TBI subgroup, the hospitalization time, ICU hospitalization time and ventilator usage time were significantly higher in ICP monitoring group (n=44) than those of no ICP monitoring group (n=116, P＜0.05). Conclusion It is found that ICP monitoring can reduce the incidence of AKI and 20% mannitol usage, and have a benefit effect on helping to obtain more precise control of the electrolyte and fluid balance in TBI patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the auxiliary effect of non-invasive ICP monitoring on the treatment of PADBS patients and to provide reference for the clinical application of noninvasive ICP detection. Metiiods: The clinical data of 114 patients with PADBS in our department of neurosurgery from January 2011 to January 2016 were retrospectively analyzed. According to inclusion and exclusion criteria, 53 cases in the case group and 61 cases in the control group were collected. Non-invasive intracranial pressure monitoring and invasive intracranial pressure monitoring were used respectively. Comparison and survival analysis were carried out according to patients' data. Results: The patients with intracranial pressure and mean pressure type number, the case group and the control group there was no significant difference between the values of different types of intracranial pressure detection (P>0.05); analysis of large bone flap craniotomy in the survival time in patients with 48h, patients the median operative time was 35.6 months, the control group DFS was 33.5 months. There was no significant difference in survival curve, the operation time was detected in two groups (P>0.05); a ICP detection rate of 3.2% patients with secondary hemorrhage, cerebrospinal fluid infection condition was 7.9%; the prognosis of two groups were no significant difference (P>0.05). The number of hospitalized patients with noninvasive ICP was shorter than that of invasive ICP (P<0.05). Conclusion: The clinical value of non-invasive ICP in the treatment ofPADBS is equivalent to that of invasive ICP, but non-invasive ICP is more convenient and less invasive, which is beneficial to the continuous detection of patients. [ABSTRACT FROM AUTHOR]

Objective To research the value of cisterna ambiens classification of CT imaging and intraoperative continuous monitoring of intracranial pressure( ICP) in patients with severe traumatic brain injury( s TBI) before and after operation. Methods ICP monitoring and brain CT examination of twenty-five patients who underwent craniectomy after severe traumatic brain injury were performed. The ICP value and cisternal grades were recorded,and cisterna ambiens degree was classified as followings: Grade Ⅰ: The central pool of occlusion; Grade Ⅱ: 0. 1-1. 0 mm; Grade Ⅲ:1. 0-2. 0 mm; Grade Ⅳ: > 2. 0 mm. Five point Glasgow outcome( GOS) was used for outcome assessment after six months after operation. Outcome is further classified into favourable( GOS scores4,5) and unfavourable( GOS scores 3 to 1) for analysis. Then,statistical analyses were performed based on these factors( cisternal grades,ICP and prognosis). Results Cisternal grade was found to be not influencing the outcome of patients with severe traumatic brain injury before operation. Found a negative correlation between basal cisterns classification and ICP level after operation; and the lower the basal cisterns classification,the higher the ICP,The difference between different groups is statistically significant. Found a correlation between cisterna ambiens classifications,ICP level and prognosis. Strongest correlation was found between prognosis and ICP72 h after operation. The ICP value of unfavourable prognosis group is much significantly higher than the ICP value of favourableprognosis group. Having found that ICP72 h is a strong predictor outcome( considering favourable outcome). ROC curve was made for finding out the optimal cutoff( ICP72 h= 21 mmHg) as a predictor. Conclusions Cisterna ambiens classification can reflect ICP level,and ICP72 h is superior to cisterna ambiens classification for assessing prognosis of craniectomy patients with traumatic brain injury. Cisternal grade and continuous ICP in the treatment of preoperative and postoperative patients with sTBI contribute to identify problems timely and guide therapy and assess prognosis,and play an important clinical value treatment of sTBI patients. [ABSTRACT FROM AUTHOR]

Objective To study the clinical effect of mild hypothermia under intracranial pressure( ICP)monitoring in the treatment of severe traumatic brain injury( sTBI). Methods A total of 100 patients with s TBI were enrolled in the study. They were randomly divided into the control group and the observation group by random number table method,50 cases in each group. All patients were given symptomatic treatment after admission. The observation group were additionally given mild hypothermia therapy and the rectal temperature( RT) was controlled at 32 ℃ ~34 ℃,while RT of the control group was controlled at 36 ℃ ~ 37 ℃. The partial pressure of brain tissue oxygen( PbtO_2) and ICP were monitored. Changes of ICP,PbtO_2,blood lactic acid and brain derived neurotrophic factor( BDNF) in the two groups on admission,at 24 h,48 h,72 h and 96 h after admission were compared. Changes of scores of National Institutes of Health Stroke Scale( NIHSS) and Glasgow Outcome Scale( GCS) before and after treatment were recorded,and the incidence of complications in the two groups was statistically analyzed. Results( 1)On admission,there was no statistically significant difference between the two groups in ICP and PbtO_2( all P 0. 05). 24 h,48 h,72 h and 96 h after admission. ICP was decreased while PbtO_2 was increased in two admission groups. ICP was lower in the observation group whlie PbtO_2 was higher than the control group at different time points after admission( all P 0. 05).( 2) On admission,there was statistically significant differences between the two groups in levels of blood lactic acid and BDNF( all P 0. 05). 24 h,48 h,72 h and 96 h after admission,blood lactic acid levels were decreased and BDNF levels were increased in the two groups. Blood lactic acid levels were lower and BDNF levels were higher in the observation group than the control group at different time points after admission( all P 0. 05).( 3) Before treatment,there was statistically significant differences between the two groups in NIHSS score and GOS score( all P 0. 05). After 3 months of treatment,NIHSS scores of the two groups were decreased,and GOS scores were increased. After 3 months of treatment,NIHSS score of the observation group was lower than that of the control group,while GOS score was higher than that of the control group( all P 0. 05).( 4) The incidence of complications in the observation group was slightly lower than that in the control group( P 0. 05). Conclusion Mild hypothermia under ICP monitoring can quickly reduce the ICP and improve the neurological function and prognosis of patients with sTBI. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的探讨亚低温治疗对重症颅脑损伤患者术后氧代谢、脑血流及颅内压的影响。方法选取2016 年 5 月至2017 年5 月在该院治疗的68 例重症颅脑损伤患者作为研究对象，随机分为对照组和观察组，每组34 例。对照 组患者采用常规治疗，观察组患者在常规治疗基础上再进行亚低温治疗。分析比较2 组患者在治疗前，治疗3、7 d 后红 细胞沉降率（ESR）、脉搏波速（Wv）、血氧含量（CjvO2）、颈静脉球部血氧饱和度（SjvO2）、脑部平均血流速度（Vmean）、脑 部平均血流量（Qmean）、脑氧摄取率（CERO2）、动脉血氧含量（CaO2）等指标。评定2 组患者的治疗效果。结果2 组患 者在治疗前脑氧代谢、颅内压、脑血流等各项指标并无明显差异，治疗3、7 d，观察组CjvO2、SjvO2、CERO2 水平均高于对 照组，而CaO2 水平则明显低于对照组，差异均有统计学意义（P<0.05）。治疗1、3、7 d，2 组的颅内压均有所降低，但观察 组颅内压明显较对照组降低更明显，差异均有统计学意义（P<0.05）。治疗7 d，2 组患者脑血流中的Qmean、Vmean 均有 所升高，且观察组较对照组升高更明显；2 组患者的Wv、ESR 均有所降低，且观察组较对照组降低更明显，差异均有统 计学意义（P<0.05）。观察组并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。结论对重症颅脑损伤患者 术后采用亚低温治疗，能够有效降低颅内压，改善氧代谢、脑血流等各项指标，减少并发症的发生，降低致残、致死率，预 后效果显著，可有效提高患者的生存质量。 [ABSTRACT FROM AUTHOR]

Objective To explore the influence of different methods of bandaging on the postoperative intracranial pressure of patients with severe brain injury patients after decompression craniectomy. Methods The standard decompressive craniectomy was use for the 36 cases of severe traumatic brain injury patients， and the intracranial pressure monitoring sensor probe was indwelled in operaion. Two different dressing methods of elasticity mesh cap and applicator were used for the patients respectively at 0h， 72h， 120h and 168h after operation， and the value of intracranial pressure was monitored and recorded. Result The intracranial pressure of elastic cap were significantly higher than the applicator respectively in operation immediate postoperative 72h， 120h and 168h （P ＜0.05）， the difference was statistically significant. Conclusions The intracranial pressure of elastic cap is significantly higher than the applicator at different times after the surgery group. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of 7.5 % hypertonic saline and 20 % mannitol in doses of similar osmotic burden for treating intracranial hypertension.Methods:A study was conducted with patients showing intracranial pressure (ICP) > 20 mmHg lasting for 5 min. Patients were administered either 4 mL/kg 7.5 % hypertonic saline (HTS group, n = 27) or 0.5 g/kg 20 % mannitol (mannitol group, n=31), intravenously from admission. Two agents were administered as a bolus via a central venous catheter, infused for over 30 min. Data collected fromeach eligible patient included ICP, plasma osmolarity, electrolytes, and potential adverse effects associated with HTS and mannitol during administration.Results:Both agents were effective in achieving goal ICP (ICP < 20 mmHg) during infusion. There were no statistical difference between both groups in the effective rate to control intracranial hypertension, biggest drop in ICP and the mean duration of the effect (P>0.05). Plasma osmolarity in two groups increased significantly (P<0.05). Conclusion: Treatment with 7.5 % HTS and 20 % mannitol in doses of similar osmotic burden produces is effective and safe for ICP control. Both agents can be recommended as first-line agents in management of raised ICP. [ABSTRACT FROM AUTHOR]

目的 对比观察重型颅脑损伤患者改良大骨瓣减压术中渐进减压与常规减压的应用效果. 方法 重型颅脑损伤患者80例, 以随机数字表法分为对照组和观察组各40例.两组均行改良大骨瓣减压术, 对照组患者采用常规减压手术方案; 观察组采用渐进减压手术方案, 即在硬膜下血肿大部分排出后,作颞部近骨窗处切口,行硬膜外引流.分别于术前及术后1、3、5 d采用格拉斯哥昏迷评分(GCS)评价神经功能损伤程度,采用BJM428型颅内压监护仪检测颅内压.记录术后并发症发生情况,包括术后切口疝及脑脊液漏、颅内感染、外伤性癫痫及脑积水.术后3个月采用格拉斯哥预后评分(GOS)分级评价远期预后.结果 两组术后3、5 d GCS均高于术前,且观察组术后3、5 d GCS高于对照组(P均<0.05). 两组术后1、3、5 d颅内压均低于术前,且观察组术后1、3、5 d颅内压低于对照组(P均<0.05). 观察组术后切口疝及脑脊液漏、颅内感染发生率均低于对照组(P均<0.05).观察组良好、中度残疾、植物生存及死亡分级均显著优于对照组(P均<0.05). 结论 重型颅脑损伤改良大骨瓣减压术中采用渐进减压可有效促进患者受损神经功能恢复, 控制颅内压, 降低手术并发症发生率, 改善患者预后, 效果优于常规减压. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of mild hypothermia treatment on intracranial pressure (ICP). cerebral blood flow and oxygen metabolism in patients with severe traumatic brain injury (sTBI). Methods: A total of 50 patients with sTBI were collected and randomly divided into experimental group(n=25) and control group(n=25). All the patients were given routine treatment,on the basis of which the observation group was treated with mild hypothermia. The ICP dynamic changes before treatment and the 3th, 5th. 7th day after treatment and changes in cerebral blood flow and oxygen metabolism and other indexes before treatment and 7 days after treatment of the two groups were detected. Results: The differences of ICP between the two groups w ere statistically significant the 3th. 5th. 7th days after treatment (P<0.05); the ICP of two groups gradually decreased along with the increase of the treatment time, the differences were statistically significant (P<0.05). The Qmean and Vmean were increased and the DR and Wv wrere decreased 7 days after treatment, the differences between the two groups were statistically significant (P<0.05). The SjvO2 CjvO2 and CERO2 were all increased, and CaO2 decreased 7 days after treatment, the differences between the two groups were statistically significant (P<0.05). Conclusion: Mild hypothermia treatment can significantly reduce intracranial pressure and improve the levels of cerebral blood flow7 and oxygen metabolism of the patients with sTBI. [ABSTRACT FROM AUTHOR]

目的 探讨有创颅内压（ICP）持续动态监测在重型颅脑损伤（SCCI）术后治疗中的指导作用。 方法 选取2014年7月至2015年6月该科收治的SCCI行开颅术患者86例，术中植入ICP探头。根据接受治疗的方式不同，将患者随机分为研究组与对照组，各43例。对照组根据患者神志变化、生命体征和影像学检查等判断病情并进行常规治疗，研究组患者进行动态ICP监测，并根据ICP监测结果指导脱水药物动态调整治疗。对比分析两组治疗后的临床效果。 结果 研究组预后良好率[74.44%（32/43）]明显高于对照组[55.81%（24/43）]，差异有统计学意义（P<0.05）。 结论 对SCCI患者行开颅术后进行ICP持续动态监测，根据其结果可及时进行脱水药物调整，具有很高的临床指导价值。 [ABSTRACT FROM AUTHOR]

目的 探讨颅内压（ICP）监测对治疗重度脑室出血的指导作用及预后判断的意义。方法 将2013年3月至2014年12月收治的88例重度脑室出血患者随机分为ICP监护组（48例）和常规引流组（40例）。ICP监护组采用ICP监测,常规引流组未采用ICP监测,两组患者均早期进行头腰侧序贯引流,比较两组病死率、甘露醇人均使用量、并发症发生率及总体预后。结果 ICP监护组病死率与常规引流组比较,差异无统计学意义（χ2=1.76,P〉0.05）;但甘露醇人均使用量及电解质紊乱、应激性溃疡、肾功能损害等并发症发生率均低于常规引流组,恢复良好率高于常规引流组,差异均有统计学意义（P〈0.05）。结论 ICP监测和头腰侧序贯引流治疗重度脑室出血可更加准确、及时了解患者ICP变化情况,有利于早期发现颅内再出血,具有重要指导治疗意义;结合脑灌注压共同监测,合理使用脱水剂降低了并发症发生率,改善了患者预后和生活质量,具有很高的临床应用价值。 [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical effects of naloxone hydrochloride for patients with medium-heavy craniocerebral injury. Methods 124 patients with medium-heavy craniocerebral injury enrolled in our hospital were randomized into Treating group and control group evenly, and two groups showed no difference in ages, lesional location, Glasgow coma scale and surgical procedure between. Patients in control group received symptomatic treatment and conventional operation of reducing intracranial hypertension, cleaning hematoma or decompressing bone flap while victims from control group were subjected to a additional administration of naloxone hydrochloride (0. 3mg/kg/d · 7 d ). The variance of intracranial tension and prognosis were observed. Results The intracranial tension of control group in the 3rd, 5th, 7th days were (2.86 ± 0.34) kPa, (2.51 ± 0.39) kPa, (2.26 ± 0.38) kPa respectively, while Treating group were (2.48 ± 0.40) kPa, (2.21 ± 0.44) kPa, (2. 10 ± 0.38) kPa which were significantly lower than the corresponding period of Control group (all P < 0.05 ). Prognostically, the cases with outcome of favorable prognosis, death, medium handicap or severe handicap in treating group were 38, 13, 5, 6, which were markedly better than treating control group (21, 19, 9, 13 cases, respectively; P < 0.05). Conclusion Based on traditional comprehensive therapies including operation, dehydrating drugs, mild hypothermia, anticovulsants and neural nutrition medicine, naloxone hydrochloride could further alleviate the intracranial hypertension, improve the prognosis of patients with medium-heavy craniocerebral injury and presented with high clinic value. [ABSTRACT FROM AUTHOR]

目的观察异丙酚全凭静脉麻醉对颅脑损伤患者脑组织氧分压、颅内压及血流动力学的影响。方法选 取该院2015 年1 月至2017 年4 月收治的颅脑损伤患者200 例，根据麻醉实施方法的不同分为观察组（异丙酚全凭静 脉麻醉）及对照组（异氟醚静吸复合麻醉），各100 例。检测并比较2 组患者麻醉诱导前（TT1）、切头皮时（TT2）、切硬脑膜时 （TT3）脑组织氧分压、颅内压及血流动力学。结果对照组TT2、TT3 时，血流动力学指标较T1 时明显提升，且显著高于观察 组，差异均有统计学意义（P<0.05）；2 组T2、TT2 时，脑组织氧分压及颅内压均较T1 时明显变化，且观察组显著优于对照 组，差异均有统计学意义（P<0.05）。结论异丙酚全凭静脉麻醉用于颅脑损伤患者手术治疗，血流动力学稳定，有效提 升患者脑组织氧分压，颅内压显著降低，具有脑保护作用。 [ABSTRACT FROM AUTHOR]

目的探讨创伤性蛛网膜下腔出血（tSAH)患者脑血管痉挛（CVS)与颅内压（ICP)的相关性，指导临床治疗。方法选择南阳市第一人民医院神经外科2015年1月至2016年4月收治的39例tSAH患者采用经颅多普勒诊断CVS，采用闪光视觉诱发电位行无创ICP监测明确ICP，分别于发病6h、1、3、5、7d监测CVS及ICP，并进行相关性分析。结果在39例tSAH患者中有30例患者出现CVS，其中ICP升高患者34例，tSAH患者改良Fisher分级越高，CVS及ICP升高越显著，经相关性分析CVS与ICP升高呈显著正相关（r=0.892，P<0.01)。结论在tSAH患者临床中治疗，早期控制CVS对降低ICP及改善预后有重要意义。 [ABSTRACT FROM AUTHOR]