Comparative study of gradient decompression under different types of intracranial pressure monitoring in patients with severe craniocerebral injury and cerebral herniation
Objective To investigate the effect of gradient decompression under ventricular intracranial pressure(ICP)monitoring and simple ICP monitoring in patients with severe traumatic brain injury(sTBI)and cerebral herniation.Methods Eighty-six patients with sTBI and cerebral herniation admitted to the Department of Neurosurgery,Hainan Western Central Hospital from June 2021 to June 2023 were selected as the research subjects,and were divided into group A(n=43)and group B(n=43)by random number table method.Perioperative complications,dose and time of mannitol,short-term efficacy,long-term efficacy and postoperative complications were compared between the two groups.Results The incidence of acute malignant encephalocele and delayed hematoma in group A was lower than that in group B(P＜0.05).The applied dose of mannitol in group A was lower than that in group B,and the applied time was shorter than that in group B(P＜0.05).Postoperative 24 h pupil recovery rate in group A was lower than that in group B,and Glasgow coma scale(GCS)score was higher than that in group B(P＜0.05).There was no significant difference in long-term efficacy between the two groups(P＞0.05).The incidence of postoperative complications was not significantly different between the two groups(P＞0.05).Conclusions Compared with simple ICP monitoring,gradient decompression under ventricular ICP monitoring in sTBI patients with cerebral herniation can reduce the incidence of acute malignant encephalocele and delayed hematoma,optimize the use of mannitol,improve the short-term prognosis,and do not increase postoperative complications.
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