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首页> 外文期刊>The Journal of trauma >Percutaneous tracheostomy in neurosurgical patients with intracranial pressure monitoring is safe.
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Percutaneous tracheostomy in neurosurgical patients with intracranial pressure monitoring is safe.

机译：经皮气管切开术在神经外科患者中进行颅内压监测是安全的。

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BACKGROUND: Percutaneous tracheostomy (PT) is performed routinely on neurosurgical patients in many critical care units. Some of these patients suffer from severe brain injury and require intracranial pressure (ICP) monitoring. It remains uncertain whether this procedure causes an increase in ICP or jeopardizes the cerebral perfusion pressure (CPP) in these patients. We studied the effects of PT on ICP and CPP in this group of patients. METHODS: Our study group consisted of 52 neurosurgical patients in the surgical intensive care unit of an urban, Level I Trauma Center who had ICP monitoring and underwent PT between 2001 and 2005. Data were collected from 24 hours before to 24 hours after PT. ICP, CPP, and Glasgow Coma Score (GCS) scale were measured hourly during the study period. RESULTS: There was no statistically significant change in the mean ICP over the 48-hour study period or after the procedure. There was a temporary increase in ICP during the procedure (1.60 mm Hg) which was statistically not significant. There was statistically significant increase in the mean CPP after the procedure, although this increase was clinically not significant. The risk of having a critically high ICP (>20 mm Hg) or low CPP (<60 mm Hg) values did not increase after the procedure. There was no significant change in GCS after the procedure. CONCLUSION: PT in neurosurgical patients with ICP monitor does not cause clinically significant or hazardous changes in ICP, CPP, and GCS. We therefore consider PT to be safe in neurosurgical patients.
机译：背景：经皮气管切开术（PT）通常在许多重症监护病房中对神经外科患者进行。这些患者中有一些患有严重的脑损伤，需要监测颅内压（ICP）。对于这些患者，该手术是否会导致ICP升高或危及脑灌注压力（CPP），仍不确定。我们研究了这组患者中PT对ICP和CPP的影响。方法：我们的研究组由2001年至2005年在城市一级创伤中心的外科重症监护病房中进行ICP监测并接受PT的52例神经外科患者组成。数据收集自PT之前24小时至PT之后24小时。在研究期间每小时测量一次ICP，CPP和格拉斯哥昏迷评分（GCS）量表。结果：在48小时的研究期间或手术后，平均ICP没有统计学上的显着变化。在手术过程中，ICP暂时升高（1.60 mm Hg），这在统计学上并不显着。手术后平均CPP有统计学上的显着增加，尽管这种增加在临床上并不显着。手术后，ICP极高（> 20 mm Hg）或CPP极低（<60 mm Hg）的风险并未增加。手术后GCS没有明显变化。结论：ICP监测器在神经外科患者中使用PT不会引起ICP，CPP和GCS的临床显着变化或危险变化。因此，我们认为PT在神经外科患者中是安全的。

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