扰动系数在脑出血患者脑水肿监测治疗中的作用  

Role of disturbance coefficient in monitoring and treatment of cerebral edema in patients with cerebral hemorrhage

作　　者：高文文 王凤鹿 蒋小兵 王悦 袁致海[1] 杨磊[1] 陈鹏[1] 李小强[1] 唐小璐[1] 赵海康[1] Gao Wenwen;Wang Fenglu;Jiang Xiaobing;Wang Yue;Yuan Zhihai;Yang Lei;Chen Peng;Li Xiaoqiang;Tang Xiaolu;Zhao Haikang(Department of Neurosurgery,the Second Affiliated Hospital of Xi’an Medical College,Xi’an 710038,China)

机构地区：[1]西安医学院第二附属医院神经外科,西安710038

出　　处：《中华脑科疾病与康复杂志（电子版）》2020年第5期305-308,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：陕西省重点研发计划项目资助(202OZDLSFO1-02)。

摘　　要：目的探讨无创脑水肿动态监护仪中的扰动系数(DC)在高血压脑出血辅助治疗中的临床意义。方法纳入西安医学院第二附属医院神经外科自2018年9月至2019年9月收治的160例高血压脑出血患者,随机分为对照组和试验组,每组80例。对照组采用常规经验性治疗,试验组在无创脑水肿动态监测下指导治疗。比较2组患者一般资料、甘露醇使用剂量及疗程、并发症及预后恢复情况。结果对照组的甘露醇平均每日使用量为(362.7±117.7)mL,高于试验组(283.1±93.6)mL,差异具有统计学意义(P<0.05)。并发症:对照组中肺部感染20例(25%),电解质紊乱30例(37.5%),肾功能损害20例(25%),应激性溃疡16例(20%);试验组中肺部感染18例(22.5%),电解质紊乱6例(7.5%),肾功能损害2例(2.5%),应激性溃疡15例(18.8%)。试验组住院天数明显少于对照组,出院后随访6个月,试验组预后优于对照组,差异均具有统计学意义(P<0.05)。结论对于高血压脑出血患者,住院期间持续行无创脑水肿动态监测能够指导脱水药物的使用,降低并发症、缩短住院天数、改善预后,可作为一种新的辅助治疗方法。Objective To explore the clinical significance of disturbance coefficient(DC)in a non-invasive brain edema dynamic monitor in the adjuvant treatment of hypertensive cerebral hemorrhage.Methods One hundred and sixty patients with hypertensive cerebral hemorrhage admitted to our hospital from September 2018 to September 2019 were randomly divided into the control group(n=80)and the test group(n=80).The control group was treated with routine empirical treatment,and the test group was under non-invasive brain edema dynamic monitoring under the guidance of treatment.The general information of patients,the dosage and treatment of mannitol,the recovery of complications and prognosis were compared between two groups.Results The average daily dose of mannitol in the control group was(362.7±117.7)mL,which was higher than(283.1±93.6)mL in the experimental group,and the difference was statistically significant(P<0.05).Complications:in the control group,there were 20 cases(25%)of pulmonary infection,30 cases(37.5%)of electrolyte disturbance,20 cases(25%)of renal impairment and 16 cases(20%)of stress ulcer;in the experimental group,there were 18 cases(22.5%)of pulmonary infection,6 cases(7.5%)of electrolyte disturbance,2 cases(2.5%)of renal impairment and 15 cases(18.8%)of stress ulcer.The length of stay in the experimental group was significantly less than that in the control group,the difference was statistically significant(P<0.05).After 6 months of follow-up,the prognosis of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For patients with hypertensive intracerebral hemorrhage,continuous non-invasive dynamic monitoring of cerebral edema during hospitalization can guide the use of dehydration drugs,reduce complications,shorten the length of stay in hospital,and improve the prognosis,which can be used as a new adjuvant therapy.

关 键 词：扰动系数 高血压脑出血 脑水肿 

分 类 号：R743.34[医药卫生—神经病学与精神病学]