颅内压监测对高血压性脑出血患者术后临床疗效的影响  

Effects of Intracranial Pressure Monitoring on Postoperative Clinical Efficacy in Patients with Hypertensive Cerebral Hemorrhage

作　　者：刘胜华[1] 姚庆宁[1] 唐协林[1] 黎乾科[1] 赵超[1] 钟俊[1] 肖奎[1] 

机构地区：[1]四川省三台县人民医院,四川三台621100

出　　处：《河北医学》2015年第4期567-570,共4页Hebei Medicine

基　　金：泸州医学院基金资助项目;(编号:013012)

摘　　要：目的:探讨颅内压监测对高血压性脑出血患者术后近期及远期临床疗效的影响。方法:选择合适的患者60例,随机分为观察组和对照组各30例,均给予基础治疗,对照组采用常规方法降颅压,观察组根据颅内压监测结果应用脱水剂,比较二者预后情况等。结果:术后1周两组患者NIHSS评分均低于术前,差异有统计学意义(P<0.05),但是观察组患者下降幅度较对照组大(P<0.05)。观察组患者电解质紊乱、应激性溃疡、肾功能损害的发生率明显低于对照组,差异有统计学意义(P<0.05),而两组患者感染发生率相似,差异无统计学意义(P>0.05)。随访6个月,观察组死亡率10.00%、预后良好率53.33%,对照组死亡率26.67%、预后良好率36.67%,差异有统计学意义(P<0.05)。结论:颅内压监测有助于高血压性脑出血患者术后神经功能的恢复,减少并发症,降低病死率,改善患者愈后日常生活能力。Objective： To investigate the effects of intracranial pressure monitoring on the short- term and long-term postoperative clinical efficacy in patients with hypertensive cerebral hemorrhage. Method： A total of 60 eligible patients were selected and randomly divided into observation group and control group,with30 patients in each group. All the patients were given with basic therapies. The control group used routine method to decrease intracranial pressure,while the observation group used dehydrants according to the intracranial pressure monitoring results. The prognoses were compared between the two groups.Result： The patients of both groups had decreased national institutes of health stroke scale（ NIHSS） scores at 1 week after the surgery when compared with those before the surgery,and the differences were statistically significant（ P0.05）,but the decreasing extent of the observation group was greater than the control group（ P 0. 05）.The patients of the observation group had significantly lower incidences of electrolyte disturbances,stress ulcer,and renal functional lesion than those of the control group（ P 0.05）,and the patients of the two groups had similar incidences of infection,and the difference was statistically insignificant（ P 0.05）. All the patients were followed up for 6 months; the death rate and eusemia rate of the observation group were 10.00%and 53.33%,respectively,while those of the control group were 26.67% and 36.67%,respectively,and the differences were statistically significant（ P 0.05）.Conclusion： Intracranial pressure monitoring is helpful to the postoperative neurofunctional recovery,can decrease fatality rate and incidence of complication,and can improve the activity of daily living after onset of the disease in patients with hypertensive cerebral hemorrhage.

关 键 词：颅内压监测 高血压 脑出血 脱水剂 小骨窗颅内血肿清除术 

分 类 号：R651.12[医药卫生—外科学]