颅内压监测在重症高血压脑出血微创救治中的应用  

Application of intracranial pressure monitoring in minimally invasive treatment of severe hypertensive intracerebral hemorrhage

作　　者：叶金海 李根英 欧兰珍 李成龙 骆锦标[2] 曹志恺[2] 孙树杰[3] 

机构地区：[1]广东省龙川县人民医院,517300 [2]广州医科大学附属广州市第一人民医院 [3]同济大学附属东方医院

出　　处：《中国实用医药》2015年第14期44-45,共2页China Practical Medicine

摘　　要：目的在颅内压（ICP）监控下,应用微创救治术抢救重症高血压脑出血（HICH）患者。方法 51例重症HICH患者,以微创锥颅术行侧脑室及（或）血肿腔穿刺,其中脑室引流置入ICP监测,术后持续监测ICP并通过调节脑室引流量将ICP控制在15~20 mm H2O（1 mm H2O=0.0098 k Pa）水平,同时严格控制血压,给予防治脑水肿、并发症等综合治疗,观察治疗结果。结果 51例患者中,47例得以抢救成功,3例因持续颅内高压无缓解（其中1例再出血）死亡,1例因多种并发症发生死亡。结论正常ICP监测下以微创术救治重症HICH患者安全可靠,抢救成功率高。Objective To apply minimally invasive treatment for severe hypertensive intracerebral hemorrhage （HICH） under intracranial pressure （ICP） monitoring.Methods A total of 51 severe HICH patients received paracele and （or） hematoma cavity puncture by minimally invasive cone cranial surgery, and ventricular drainage was taken into ICP monitoring. The monitoring on ICP lasted after surgery, and adjustment on drainage volume was made to control ICP in 15~20 mm H2O （1 mm H2O=0.0098 kPa）. Strict control on blood pressure and prevention of encephaledema and complications were all taken as comprehensive treatment, and curative effects were observed.Results There were 47 cases among 51 patients received successful rescue treatment, 3 death cases due to continuous high intracranial pressure （1 case of them with rehaemorrhagia）, and 1 death case due to multiple complications.Conclusion Minimally invasive treatment for severe HICH patients under normal ICP monitoring is a safe method with high success rate in rescue.

关 键 词：颅内压监测 高血压脑出血 微创救治 

分 类 号：R651.1[医药卫生—外科学]