颅内压监测在高血压脑出血治疗中的应用  

Application of intracranial pressure monitoring in treatment of hypertensive intracerebral hemorrhage

作　　者：叶亮亮 赵鹏来 薛元峰[1] 许健 杨平来 YE Liang-liang;ZHAO Peng-lai;XUE Yuan-feng(Department of Neurosurgery,Lishui Peoples s Hospital,Nanjing 211200,China)

机构地区：[1]南京市溧水区人民医院神经外科,南京211200 [2]南京医科大学附属脑科医院神经外科

出　　处：《临床神经外科杂志》2018年第6期469-472,共4页Journal of Clinical Neurosurgery

基　　金：南京市科技发展计划项目(基金编号201605077);南京市卫生青年人才培养工程(基金编号QRX 17084);南京市医学科技发展项目(基金编号YKK17230)

摘　　要：目的探讨颅内压监测在高血压脑出血患者治疗中的指导价值和临床意义。方法回顾性分析溧水区人民医院2016年1月至2017年12月50例高血压脑出血手术患者的临床资料。其中对照组25例,主要手术方式为脑内血肿清除术; ICP监测组25例,主要手术方式为脑内血肿清除+颅内压监测术。对比两组患者术后再出血和并发症的发生率,以及平均住院时间。结果术后再出血:ICP监测组为2例(8%),对照组为8例(32%);术后并发症:ICP监测组为5例(20%),对照组为12例(48%);两组术后再出血及并发症的发生率比较,差异均有统计学意义(均P <0. 05)。平均住院时间:ICP监测组为(12. 08±3. 46) d,对照组为(14. 44±4. 25) d,差异有统计学意义(P <0. 05)。结论通过持续监测颅内压值的变化,指导合理的治疗措施,可降低术后再出血及并发症的发生率及脱水剂对肝肾功能的影响,缩短平均住院时间。Objective To explore the guiding value and clinical significance of intracranial pressure(ICP)monitoring in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 50 patients with HICH from January 2016 to December 2017 were analyzed retrospectively.25 patients in the control group were treated as intracerebral hematoma clearance and 25 in the treatment group.The main surgical methods were intracerebral hematoma clearance and ICP monitoring.The incidence of postoperative rebleeding,the incidence of complications and the average length of stay of the two groups were compared.Results Postoperative rebleeding showed 2 cases(8%)were in the treatment group and 8(32%)in the control group,the difference was statistically significant(P<0.05).The incidence of clinical complications showed 5 cases(20%)were in the treatment group and 12(48%)in the control group,the difference was statistically significant(P<0.05).The average length of stay in the treatment group was(12.08±3.46)d,and the control group was(14.44±4.25)d,the difference was statistically significant(P<0.05).Conclusion Through continuous monitoring of changes in ICP and guiding reasonable treatment measures,it can reduce the side effect of dehydrating agent on liver and kidney function,shorten the average length of stay.

关 键 词：高血压脑出血 颅内压监测 平均住院时间 

分 类 号：R651.1[医药卫生—外科学]