Spiegelberg脑室内、脑实质有创颅内压探头在自发性脑出血颅内压监测的作用  

Spiegelberg intraventricular, brain parenchymal intracranial pressure probe in the monitoring of intracranial pressure in spontaneous cerebral hemorrhage

作　　者：殷捷[1] 郑玺[1] 耿卫峰 王董冬 莫拉丁[1] 王建江[1] YIN Jie;ZHENG Xei;GENG Weifeng;WANG Dongdong;Moradin;WANG Jianjiang(Department of Neurosurgery, 474 Hospital, People′s Liberation Army, Urumqi 830013, China)

机构地区：[1]解放军第474医院神经外科,乌鲁木齐830013

出　　处：《新疆医科大学学报》2019年第4期513-517,共5页Journal of Xinjiang Medical University

基　　金：解放军第474医院重点扶持科研项目(2018474003)

摘　　要：目的探讨Spiegelberg脑室内、脑实质有创颅内压探头在自发性脑出血颅内压中的监测作用。方法选择2018年6月-12月解放军第474医院收入的自发性脑出血患者60例,采用随机数字表法将纳入的病例分为实验组和对照组。2组患者均行脑室、血肿穿刺引流或显微镜下开颅清除血肿。对照组30例给予脱水、维持血压稳定、止血、抗感染等常规治疗。实验组在常规治疗的基础上,通过使用Spiegelberg脑室内、脑实质有创内压探头持续进行有创颅内压监测,根据颅内压监测数值,随时调整药物使用及判断病情。评价2组患者术前及术后GCS评分,出院3个月后,通过门诊随访和电话随访方式了解患者神经功能恢复情况,应用格拉斯哥预后评分(GOS)标准进行评估。分别对术后患者1、3、7 d的颅内压进行测量,对照组术后颅内压通过间断腰椎穿刺进行测量,实验组术后颅内压通过探头连接的颅内压检测仪进行监测。结果出院时对照组GCS评分明显高于实验组(P<0.05),与对照组比较,实验组的住院天数明显减少(P<0.05),在不同时间点,2组颅内压之间差异无统计学意义(P>0.05)。无论在甘露醇人均使用量还是甘露醇总量的比较中,实验组的甘露醇用量均明显低于对照组(P<0.05)。实验组肾功能损害的发生率也明显低于对照组,差异有统计学意义(P<0.05)。实验组治疗后GOS评分为4～5分所占比例明显高于对照组,差异有统计学意义(P<0.05)。结论持续有创颅内压监测在高血压脑出血的治疗中能够及时发现颅内压的变化情况,是观察颅脑疾病患者病情变化、判断手术时机、指导临床用药和评估预后的必备手段之一。Objective To investigate the effect of Spiegelberg intraventricular and intracranial invasive intracranial pressure probes in intracranial pressure of spontaneous cerebral hemorrhage. Methods 60 patients with spontaneous cerebral hemorrhage admitted to the 474 th Hospital of the People′s Liberation Army from June to December 2018 were enrolled. The patients were divided into experimental group and control group. Both groups underwent ventricle, hematoma puncture drainage or microscopic craniotomy to remove hematoma. In the control group, 30 patients were given conventional treatments such as dehydration, stable blood pressure, hemostasis, and anti-infection. On the basis of conventional treatment, the experimental group continued to perform invasive intracranial pressure monitoring by using Spiegelberg intraventricular and intracerebral parenchymal intravascular pressure probes. According to the intracranial pressure monitoring values, the drug use and judgment were adjusted. The preoperative and postoperative GCS scores of the 2 groups were evaluated. After 3 months of discharge, the neurological recovery was analyzed by outpatient follow-up and telephone follow-up. The Glasgow Outcome Score(GOS) criteria were used for evaluation. The intracranial pressure was measured at 1, 3, and 7 days after operation. Intraoperative intracranial pressure was measured by intermittent lumbar puncture in the control group, and the experimental group was measured by lumbar puncture. The intracranial pressure of the experimental group was measured by the intracranial pressure detector connected by the probe monitor. Results The GCS score of the control group was significantly higher than that of the experimental group at the time of discharge(P<0.05). Compared with the control group, the number of hospital stays in the experimental group was also significantly decreased(P<0.05). There was no difference between the two groups at different time points(P>0.05). Regardless of the per capita consumption of mannitol or the total amou

关 键 词：Spiegelberg 有创颅内压探头 自发性脑出血 颅内压监测作用 

分 类 号：R722.15[医药卫生—儿科]