| Summary: | Objective: To explore the clinical value of dynamic ultrasound monitoring of optic nerve
sheath diameter (ONSD) in the treatment of patients with moderate and severe head injury (CI).
Methods: A total of 160 patients with moderate and severe CI admitted to the First Affiliated
Hospital of Hainan Medical University from January 2018 to January 2020 were selected and
divided into observation group (80 cases) and control group (80 cases) a Januaryccording to
the random number table. Patients in control group and observation group were dehydrated
to reduce intracranial pressure (ICP) according to clinical symptoms / brain CT and ONSD
monitoring guidance. National Institutes of Health Stroke Scale (NIHSS), Acute Physiology
and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), Glasgow Coma Scale (GCS), complications,
prognosis, ICU stay time and mechanical ventilation time were compared between the two
groups. Results: NIHSS score [control group: (19.58 ± 3.19) points vs (37.98 ± 5.75) points,
observation group: (10.33 ± 2.42) points vs (38.05 ± 5.83) points] and APACHE II score
[control group: (14.55 ± 2.17) points vs (19.87 ± 3.50) points, observation group: (8.71 ± 2.03)
points vs (20.12 ± 3.56) points] of the two groups at 1 month after injury were significantly
lower than those at admission (P < 0.05), GCS score [control group: (10.78 ± 1.66) points vs
(8.03 ± 1.34) points, observation group: (13.10 ± 1.72) points vs (7.99 ± 1.32) points] were
significantly higher than that at admission (P < 0.05). At 1 month after injury, NIHSS score
[(10.33 ± 2.42) points vs (19.58 ± 3.19) points], APACHE II score [(8.71 ± 2.03) points vs
(14.55 ± 2.17) points] in the observation group were significantly lower than those in the
control group (P < 0.05), and GCS score [(13.10 ± 1.72) points vs (10.78 ± 1.66) points] in
the observation group was significantly higher than that in the control group (P < 0.05). The
proportion of hydrocephalus (2.50% vs 12.50%), total complication rate (5.00% vs 21.25%),
proportion of severe disability (5.00% vs 17.50%), proportion of survival in plant man (3.75%
vs 15.00%), mortality rate (2.50% vs 12.50%), ICU stay time [(5.01 ± 1.25) d vs (8.38 ±
2.29) D], mechanical ventilation time [(2.18 ± 0.75) D] in observation group were lower than
those in the control group, and the good rate (56.25% vs 32.50%) and the total effective rate
(93.75% vs 72.50%) in the control group were significantly higher than those in the control
group (P < 0.05). Conclusion: Dynamic ultrasound monitoring ONSD is effective in guiding
dehydration treatment of patients with moderate and severe CI, it can significantly reduce ICP
and complications, improve prognosis, which is worthy of promotion and application.
|
|---|
