颅内压监测对创伤性脑损伤患者短期预后及 急性肾损伤发生的影响.

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]