颅内压监测联合镇静镇痛治疗高血压脑出血破入脑室的疗效分析  

Clinical analysis of intracranial pressure monitoring combined with sedation and analgesia in treating hypertensive intracerebral hemorrhage broken into ventricles

作　　者：武孝刚 王金标[1] 许少年 袁杰 张永明[1] Wu Xiaogang;Wang Jinbiao;Xu Shaonian;Yuan Jie;Zhang Yongming(Department of Neurosurgery,The No.105 Hospital of PLA,Hefei 230031,China)

机构地区：[1]解放军第一〇五医院神经外科,合肥230031

出　　处：《中华神经创伤外科电子杂志》2018年第4期209-212,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：2014年南京军区医学科技创新重点课题(14ZD17)

摘　　要：目的分析动态颅内压监测联合镇静镇痛治疗高血压脑出血破入脑室的疗效。方法回顾性分析解放军第一〇五医院神经外科自2015年1月至2017年12月收治的169例高血压脑出血破入脑室同时行侧脑室外引流术患者的临床资料,其中颅内压监测联合镇静镇痛治疗患者57例(监测治疗组)、镇静镇痛治疗患者69例(治疗组)和对照组43例。所有病例均随访6个月,比较各组神经功能缺损程度、GCS评分、GOS评分及NICU入住时间以及甘露醇使用等情况。结果监测治疗组1月及6月神经功能缺损评分、GCS评分、GOS评分及NICU入住时间等均显著优于治疗组和对照组,且甘露醇使用量、肾功能损害及电解质紊乱发生率等均显著减少,差异具有统计学意义(P<0.05)。结论持续颅内压监测可动态把握高血压脑出血破入脑室颅内压变化情况,能够避免脱水剂的过度使用,改善预后,同时联合镇静镇痛治疗效果更显著,适合临床推广应用。Objective To evaluate clinical analysis of intracranial pressure monitoring combined with sedation and analgesia in treating hypertensive intracerebral hemorrhage broken into ventricles. Methods Retrospective analysis of 169 patients diagnosed as hypertensive intracerebral hemorrhage into the ventricles of the brain, assigned to Monitoring and treatment group （n=57）, treatment group （n= 69） and control group （n=43） according to clinical practice. All patients was performed the external brain drainage, while the monitoring and treatment group were monitored by dynamic intracerebral intracranial pressure monitoring with sedative and analgesia. And the treatment group was treated with sedative and analgesia. Nerve function defect degree, GCS score, GOS score, time of NICU hospitalization and etc. were eompared in each group after 6 months of follow-up. Results Neurological deficit seore, GCS score, GOS score, NICU hospitalization time, and treatment group were significantly better than that of the treatment group and the control group （P〈0.05）, and the amount of mannitol and the rate of impaired renal function and electrolyte disorders were reduced significantly （P〈0.05）. Conclusion Intraeranial pressure monitoring, can accurately understand the changes of intraeranial pressure in patients with hypertensive intraeerebral hemorrhage broken into ventricles, avoiding overuse of dehydrating agent and improving the prognosis. While that combined sedation and analgesia treatment has more significant effect, which is suitable for clinical application.

关 键 词：颅内压监测 镇静镇痛 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]