实时、持续无创颅内压监测在高血压脑出血治疗中的应用价值  

Application Value of Real-time and Continuous Non-invasive Intracranial Pressure Monitoring in the Treatment of Hypertensive Intracerebral Hemorrhage

作　　者：高明霞[1] 黄国权[1] 李仲展 任燕华[1] 蔡英丽[1] GAO Mingxia;HUANG Guoquan;LI Zhongzhan(Zhaoqing First People’s Hospital,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526000

出　　处：《中国医学创新》2018年第3期24-27,共4页Medical Innovation of China

基　　金：肇庆市科技创新指导类项目(2016040308)

摘　　要：目的:探讨闪光视觉诱发电位对无创颅内压(noninvasive intracranial pressure,NICP)和脑灌注压(cerebral perfusion pressure,CPP)变化监测在治疗高血压脑出血中的应用价值。方法:本研究纳入2014年1月-2016年12月就诊于本院ICU的高血压脑出血患者80例,采用随机数字表法1∶1对照将患者分为试验组和对照组,各40例。对照组给予常规治疗,试验组在闪光视觉诱发电位监测无创颅内压和脑灌注压情况下进行脑出血的治疗,比较两组患者的治疗效果。结果:与治疗前比较,两组患者治疗后的颅内压均下降,脑灌注压均升高(P<0.05),试验组变化均较对照组更为明显(t=-3.652、6.349,P=0.001、0.001)。试验组患者的甘露醇使用量明显低于对照组,差异有统计学意义(t=-15.921,P=0.001)。试验组的治愈率为70.0%,高于对照组的47.5%,差异有统计学意义(x^2=4.178,P=0.034)。结论:闪光视觉诱发电位可以对高血压脑出血患者进行实时、持续的无创监测,并指导临床用药,可以有效提高治愈率,具有临床应用和推广价值。Objective:To investigate the application value of flash visual evoked potential in the monitoring of the noninvasive intracranial pressure and cerebral perfusion pressure for patients with hypertensive intracerebral hemorrhage.Method:80 hypertensive cerebral hemorrhage patients treated from January 2014 to December 2016 in our ICU department were selected,the patients were divided into experimental group and control group by 1∶1 random digital table method,40 cases in each group.The control group adopted the conventional therapy,the experimental group adopted the flash visual evoked potential to monitor the intracranial pressure and cerebral perfusion pressure,the clinical effect of the two groups were compared.Result:Compared with pretreatment,the intracranial pressure of both groups decreased and the cerebral perfusion pressure of both groups increased(P<0.05),the changes in the experimental group were more obvious than those in the control group(t=-3.652,6.349;P=0.001,0.001).The amount of Mannitol used in the experimental group was significantly lower than that of the control group,and the difference was statistically significant(t=-15.921,P=0.001).The cure rate of the experimental group was 70.0%,which was higher than 47.5%of the control group,the difference was statistically significant(Χ2=4.178,P=0.034).Conclusion:The flash visual evoked potential can be used for real-time and continuous noninvasive monitoring of hypertensive cerebral hemorrhage patients,and the clinical application can be guided,so that the curative rate can be effectively improved,and the method has clinical application and popularization value.

关 键 词：高血压脑出血 闪光视觉诱发电位 无创颅内压 脑灌注压 监测 

分 类 号：R743.34[医药卫生—神经病学与精神病学]