目的 探讨重型颅脑损伤非血肿性高颅压与手术减压程度的相关性.方法 选取2008年9月至2012年1月入住我院并进行手术治疗的重型颅脑损伤非血肿性高颅压患者568例,所有患者入院后均行格拉斯哥(GCS)评分,为减少GCS评分对预后的影响,在病例遴选过程中选取GCS评分为4分的患者作为研究对象.所有患者出院时均行格拉斯哥预后评价标准(GOS)评估,患者按照手术期间的减压程度进行分组,分析组间的预后数据.结果 术后颅内压仍然偏高的术后高压组患者的死亡率(78.8％)明显高于术后低压组(39.3％)和术后正常组(23.5％),而术后低压组的良好率高于术后高压组,术后颅内低压患者组出现植物生存患者的概率(10.7％)均高于其余两组.结论 重型颅脑损伤非血肿性高颅压患者手术减压后应尽量使颅内压维持在正常范围并偏低的状态,以期降死亡率.%Objective To investigate the correlation of high intracranial pressure and surgical decompression degree in severe traumatic brain injury with non-hematoma. Methods Five hundred and sixty-eight patients of severe traumatic brain injury with high intracranial pressure not because of hematoma were performed surgical treatment from September 2008 to January 2012, GCS Glasgow score (GCS) was recorded. In order to reduce the GCS score influence on the prognosis in of the selection process, the patients with GCS score of 4 were selected as the research objects. When Discharged, all the patients were carried out Glasgow Outcome evaluation criteria (GOS) assessment, patients are grouped according to the degree of surgical decompression, and the data of the prognosis were analyzed among the groups. Results The mortality rate in the postoperative hypertension group (78.8%) was significantly higher than that in the postoperative low-pressure group (39,3%) and postoperative normal group (23.5%); the well rate in the postoperative low-pressure group was significantly higher than that in the postoperative hypertension group; the probability of plant survival (10.7%) in postoperative intracranial hypotension group were higher than that in the other two groups. Conclusion Postoperative intracranial pressure should be maintained in the state of low normal range to reduce mortality in severe traumatic brain injury with non-hematoma.
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