颅内压监测在幕上高血压脑出血患者治疗中的应用  

Application value of intracranial pressure monitoring in the treatment of patients with hypertensive intracerebral hemorrhage

作　　者：罗灼明 方志伟[1] 朱灼坤 罗伟鹏 刘云[1] 王振宁[1] 陈桂增[1] 

机构地区：[1]东莞市人民医院神经外科,广东东莞523059

出　　处：《海南医学》2017年第7期1085-1087,共3页Hainan Medical Journal

摘　　要：目的探讨颅内压(ICP)监测在幕上高血压脑出血患者治疗中的应用价值。方法将2010年2月至2016年2月在我院神经外科诊治的98例幕上高血压脑出血患者根据随机数表法分为对照组和观察组,每组49例,对照组患者给予常规神经外科治疗,观察组患者依照ICP变化情况制定治疗措施,比较两组患者的治疗效果。结果观察组患者的治疗总有效率为75.5%,明显高于对照组的46.9%,差异有统计学意义(P<0.05);观察组和对照组患者的甘露醇使用量[(925.32±301.28)g vs(1 455.83±311.25)g]、使用时间[(7.64±4.58)d vs(14.35±4.59)d]、ICU监护时间[(21.48±4.13)h vs(40.39±4.12)h]、急性肾功能不全及水电解质紊乱(4.1%vs 26.5%)、颅内感染发生率(2.0%vs 12.2%)比较,观察组均低于对照组,差异均有统计学意义(P<0.05)。结论持续ICP监测能及时准确判断幕上脑出血患者病情变化,指导临床诊疗,从而改善预后。Objective To investigate the value of intracranial pressure（ICP） monitoring in the treatment of patients with hypertensive intracerebral hemorrhage. Methods According to random number table, 98 patients with hypertensive cerebral hemorrhage from Feb. 2010 to Feb. 2016 were divided into control group（n=49 cases, routine treatment） and the observation group（n=49 cases, adjust the treatment plan according to the changes in ICP）. The treatment results of two groups were compared. Results The effective rate of the observation group（75.5%） was significantly higher than that in the control group（46.9%）, P〈0.05. The mannitol use, the use of time, ICU monitoring time, incidence of acute renal dysfunction, incidence of electrolyte disturbance and intracranial infection were（925.32±301.28） g,（7.64±4.58） d,（21.48±4.13） h, 4.1%, 2.0% in the observation group, as compared with（1 455.83±311.25） g,（14.35±4.59） d（40.39±4.12） h, 26.5%, 12.2% in the control group（all with P〈0.05）. Conclusion Continuous ICP monitoring can timely and accurately judge the change of patients with hypertensive cerebral hemorrhage, provide a reliable reference for early treatment of disease, and thus improve the prognosis.

关 键 词：甘露醇 高血压 脑出血 颅内压监测 

分 类 号：R743.34[医药卫生—神经病学与精神病学]