持续颅内压监测辅助下治疗老年高血压脑出血的临床分析  

Clinical analysis of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage

作　　者：崔刚[1] 杨海峰[1] 孙跃春[1] 李宾[1] 王秀芹[1] 张智波[1] 

机构地区：[1]北京市健宫医院神经外科,100054

出　　处：《中国综合临床》2016年第8期728-731,共4页Clinical Medicine of China

摘　　要：目的：探讨持续颅内压监测辅助下治疗老年高血压脑出血的临床价值。方法回顾性分析217例老年高血压脑出血患者的临床资料，比较105例实施脑实质内颅内压监测患者（监测组）和112例未实施颅内压监测患者（对照组）应用甘露醇的次数及总量、并发症及预后。结果监测组和对照组甘露醇使用次数分别为（42.1±5.4）次和（59.5±8.2）次，两组甘露醇使用总量分别为（820.1±114.8） g及（1187.7±241.5） g，监测组甘露醇使用次数及总量均低于对照组（P值分别为0.032及0.011）。两组患者肺部感染及应激性溃疡发生率比较差异均无统计学意义（ P值分别为0.608和0.471）；监测组患者急性肾功能不全、水电解质紊乱发生率分别为11.4％（12／104）、28.6％（30／105），对照组分别为29.6％（33／112）、41.9％（47／112），两组比较差异均有统计学意义（P值分别为0.004、0.036）。监测组预后优良率明显高于对照组（分别为72％、48％，χ2＝13.02，P＜0.01）。结论持续颅内压监测在老年高血压脑出血治疗过程中有重要的指导意义。Objective To evaluate the clinical value of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage.Methods The clinical data of 217 cases of old patients with hypertensive cerebral hemorrhage, including 105 patients underwent continuous monitoring of intracranial pressure（monitoring group） and 112 patients without monitoring of intracranial pressure（control group）,were retrospectively analyzed.The times and the total dosage of mannitol, the complications and prognosis of two groups were compared.Results The times and the total dosage of mannitol of monitoring group was respectively （42.1±5.4） times and （ 820.1±114.8） g,significantly less than that of control group（（59.5±8.2） times, （1187.7±241.5） g;P=0.032,0.011）.The rate of pulmonary infection and stress ulcer showed no significant difference between two groups （ P = 0.608, 0.471 ）.The rate of acute renal insufficiency and electrolyte disturbances was significantly lower in the monitoring group than that in the control group （ 11.4%（ 12/104 ） vs.29.6%（ 33/112 ） , 28.6%（ 30/105 ） vs.41.9%（ 47/112 ）;P = 0.004, 0.036 ）.The prognosis of the monitoring group was better than that of the control group（72% vs.48%;χ2=13.02,P〈0.01）.Conclusion Intracranial pressure monitoring has an important value for the treatment of old patients with hypertensive cerebral hemorrhage.

关 键 词：颅内压 高血压 脑出血 甘露醇 

分 类 号：R493[医药卫生—康复医学]