颅内压监测下高血压脑出血脑室外引流速度调控的临床研究  

Adjustment of external cerebral drainage velocity by intracranial pressure monitoring for hypertensive intracerebral hemorrhage

作　　者：周秀红[1] 杨倬 魏丽[1] 张清[1] 管玉梅[1] 尹夕龙[1] Zhou Xiuhong;Yang Zhuo;Wei Li;Zhang Qing;Guan Yumei;Yin Xilong(Department of Neurosurgery,Longgang Central Hospital,Shenzhen 518116,China;Longgang Health Supervision Institute,Shenzhen 518172,China)

机构地区：[1]深圳市龙岗中心医院神经外科,518116 [2]深圳市龙岗区卫生监督所,518172

出　　处：《国际医药卫生导报》2018年第22期3430-3433,共4页International Medicine and Health Guidance News

基　　金：深圳市龙岗区科技创新委员会课题（2016060616335714）

摘　　要：目的探讨高血压脑出血患者脑室穿刺外引流速度与引流时程的关系.方法将入选病例按引流速度和引流量分为A、B、C三组,通过持续颅内压监测观察患者引流速度与ICP值的变化,动态调整引流速度以满足符合病人病情的ICP值,记录引流量和ICP值.结果剔除C组,B组ICP正常率高于A组（χ2=4.63,P 〈0.05）.两组SPO2 差异无统计学意义（P 〉0.05）,而两组调整次数、引流时程、引流量、血压、CPP变化差异有统计学意义（均P 〈0.05）,B组优于A组.结论ICP监测下调整脑室外引流速度,能有效维持理想的颅内压水平,降低脑灌注不当的风险,减少甘露醇用量,避免干预过度,缩短置管时程,降低置管风险,节省患者费用.Objective To investigate the relationship between drainage velocity and drainage time in patients with hypertensive intracerebral hemorrhage. Methods The selected cases were divided into group A, group B, and group C. The changes of drainage velocity and ICP value were observed by continuous intracranial pressure monitoring. The drainage speed was dynamically adjusted to meet the ICP value of the patients＇ conditions. The drainage fow and the ICP value were recorded. Results Group C was excluded; the normal ICP rate was higher in group B than in group A （χ2=4.63, P 〈 0.05）; there was no statistical difference in SPO2 （P〉 0.05）, but were in the adjustment time, drainage duration, drainage volume, blood pressure, and CPP changes between the two groups （all P 〈 0.05）; group B was superior to group A. Conclusions The adjustment of external cerebral drainage velocity by intracranial pressure monitoring can maintain ideal intracranial pressure level, reduce the risk of improper cerebral perfusion and catheterization and mannitol usage, avoid excessive intervention, shorten catheterization time, and save the patients’ cost.

关 键 词：高血压脑出血 脑室外引流 引流速度 引流时程 ICP监测护理 

分 类 号：R651.1[医药卫生—外科学]