实时颅内压监测下脑室外引流治疗脑干出血临床分析  

Clinical analysis of brain stem hemorrhage treated with extraventricular drainage under actually intracranial pressure monitoring

作　　者：陈国昌 石小峰 刘政委 陆云涛[2] CHEN Guochang;SHI Xiaofeng;LIU Zhengwei;LU Yuntao(Longgang District Central Hospital of Shenzhen,Shenzhen 518016,China;Southern Medical University Southern Hospital,Ghuangzhou 510080,China)

机构地区：[1]深圳龙岗中心医院,广东深圳518016 [2]南方医科大学南方医院,广东广州510080

出　　处：《中国实用神经疾病杂志》2020年第7期589-592,共4页Chinese Journal of Practical Nervous Diseases

基　　金：深圳市科技计划项目(编号:JCYJ20170306140444161)。

摘　　要：目的探讨实时颅内压监测下脑室外引流治疗脑干出血的临床效果。方法选取自发性脑干出血患者50例,随机分为手术组25例与保守组25例,手术组患者给予脑室外引流及颅内压监测,保守组患者入院后行常规药物治疗;观察2组治疗后30 d的预后情况、住院时间及并发症情况(包括上消化道出血、电解质紊乱及肺部感染)。结果手术组重度残疾及死亡占16.0%(4/25),保守组为44.0%(11/25),2组比较差异有统计学意义(P<0.05);手术组住院时间(18.3±1.7)d,保守组为(22.8±2.9)d,2组比较差异有统计学意义(P<0.05);手术组并发症发生率48.0%(12/25),保守组为76.0%(19/25),2组比较差异有统计学意义(P<0.05)。结论对于脑干出血患者,早期实时颅内压监测下脑室外引流,不仅可以降低致残率及致死率,而且减少了并发症,缩短了患者住院时间。Objective To investigate the clinical significance of extraventricular drainage under actually intracranial pressure monitoring in the treatment of patients with brain stem hemorrhage.Methods Fifty patients with spontaneous brainstem hemorrhage were randomly divided into 25 cases in the surgery group and 25 cases in the conservative group.The patients in the surgery group were given extraventricular drainage and intracranial pressure monitoring.The patients in the conservative group were treated with conventional drugs after admission.The prognosis,length of hospital stay and complications(including upper gastrointestinal bleeding,electrolyte disturbance and pulmonary infection)at 30 days after treatment in the groups were observed.Results Severe disability and death accounted for 16.0%(4/25)in the surgery group,and 44.0%(11/25)in the conservative group.The difference between the two groups was statistically significant(P<0.05).The length of hospital stay in the surgery group(18.3±1.7)days,the conservative group was(22.8±2.9)days,the difference between the two groups was statistically significant(P<0.05).The complication rate in the surgical group was 48.0%(12/25),and the conservative group was 76.0%(19/25),the difference between the two groups was statistically significant(P<0.05).Conclusion For patients with brain stem hemorrhage,early real-time intracranial pressure monitoring under ventricular extraventricular drainage can not only reduce disability and mortality,but also reduce complications and shorten the hospital stay.

关 键 词：脑干出血 高血压脑出血 颅内压监测 脑室外引流 手术治疗 

分 类 号：R743.34[医药卫生—神经病学与精神病学]