颅内压与脑灌注压持续监护在急性颅内血肿救治中的应用价值  

Monitoring of intracranial pressure and cerebral perfusion pressure in treatments of acute intracranial hematoma

作　　者：杨利孙[1,2] 章翔[1,2] 程娟丽 费舟[1,2] 付洛安[1,2] 

机构地区：[1]第四军医大学西京医院神经外科,中国人民解放军神经外科研究所,西安710032 [2]西安医科大学附属二院高干病房

出　　处：《中国急救医学》2000年第12期705-707,共3页Chinese Journal of Critical Care Medicine

基　　金：全军"九五"医学科研规划基金资助项目!(NO 98M10 1)

摘　　要：目的　探讨颅内压 (ICP)和脑灌注压 (CPP)监护在急性颅内血肿救治中价值。方法　选择两组病人进行病例对照研究。监护组 :对 6 5例急性颅内血肿患者进行了持续ICP监测和CPP监测 ,根据监测结果进行治疗 ;非监护组 :6 5例病情相似的患者按常规治疗 ,不做ICP监测和CPP监测。结果　监护组 6 5例在治疗前ICP均增高 ,5 6例CPP降低 ;ICP和CPP数值高低与治疗效果有比较密切的关系。两组病人治疗效果有明显差别 ,监护组死亡率 12 3% ,非监护组 2 0 %。监护组人均甘露醇用量、电解质紊乱及少尿型肾衰发生率均低于非监护组。结论　ICP和CPP监护在颅内血肿救治中具有积极意义 ,可以明显提高治疗效果 。Objective To investigate the value of intracranial pressure(ICP) monitoring and cerebral perfusion pressure (CPP) monitoring in the treatment of acute intracranial hematoma.Methods Two groups of patients with acute intracranial hematoma were studied comparatively.Group Ⅰ included 65 cases,on whom ICP monitoring and CPP monitoring were carried out,and their treatment were based on the monitoring data.Group Ⅱ included 65 cases which were similar to the above group in conditions on admission to our hospital,on whom the treatment were performed routinely,with no monitoring of ICP and CPP.Results Before treatment,group Ⅰ showed ICP elevated in all cases,and CPP lowered in 56 cases.The changes of ICP and CPP were related to patient outcome.Result of treatment was different between these two groups,with mortality rate 12.3% in group Ⅰ and 20.0% in group Ⅱ.In group Ⅰ,mean dosage of mannital administrated,incidence of electrolytes disbalance and liguria renal failure were all much lower than those in group Ⅱ.Conclusion Monitoring of ICP and CPP play an aggressive role in the treatment of acute cranial hematoma,which could increase the treatment result,and decrease the use of dehydrant and its related complications.

关 键 词：颅内压 脑灌注压 急性颅内血肿 监护 

分 类 号：R651.1[医药卫生—外科学]