颅内压及中心静脉压监测在脑水肿治疗中的应用  

Application of intracranial pressure and central venous pressure monitoring in the treatment of cerebral edema

作　　者：张超[1] 张鹏[1] 宋建荣[1] 吕新文[1] 周小龙[1] 朱峰[1] 蔡珂[1] 何蓓[1] 梁媛[1] ZHANG Chao ZHANG Peng SONG Jianrong LV Xiraven ZHOU Xiaolong ZHU Feng CAI Ke HE Bei LIANG Yuan(Department of Neurosurgery, Baoji Central Hospital, Baoji 721008, China)

机构地区：[1]宝鸡市中心医院神经外科,陕西宝鸡721008

出　　处：《中华神经外科疾病研究杂志》2017年第2期138-141,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨联合监测颅内压(ICP)及中心静脉压(CVP)在重型颅脑损伤患者伤后脑水肿治疗中的临床应用价值。方法 45例重型颅脑颅脑损伤患者随机分为对照组(21例)及治疗组(24例)。对照组以常规治疗方法控制ICP;治疗组在常规治疗基础上,联合监测ICP及CVP,并根据监测结果调整治疗方案。治疗终结后随访半年,采用格拉斯哥预后评分(GOS)对患者恢复情况进行评分。结果治疗组1周内日均甘露醇用量较对照组显著减少(P<0.01);治疗组GOS评分较对照组显著提高(P<0.05)。结论 ICP及CVP联合监测既能保证ICP的精准调控,又能保证血容量的平衡,可改善重型颅脑损伤患者的预后。Objective The clinical value of monitoring of intracranial pressure （ICP） and central venous pressure （CVP） for the treatirent of brain edema in the patients with severe craniocerebral injury. Methods A total of 45 cases of severe craniocerebral injury were randomly divided into control group （21 cases） and treatment group （24 cases）. The patients in control group were treated with conventional therapy to control ICP, while the patients in treatment group were monitored ICP and CVP in combination with the conventional treatment. And the treatment was adjusted according to the monitoring results. Six months after the treatment, the patients＇recovery was evaluated using the Glasgow Outcome Scale （COS）. Results The daily dose of mannitol in the treatment group was significantly lower than that in the control group within 1 w （P 〈0.01）. The GOS of the treatnent group was significantly higher than that of the control group （P 〈0.05）. Conclusion Monitoring of ICP and CVP can not only ensure the precise regulation of ICP, but also ensure the balance of blood volume, which can irrprove the prognosis of patients with severe craniocerebral injury.

关 键 词：颅内压 中心静脉压 颅脑损伤 脑水肿 

分 类 号：R651[医药卫生—外科学]