动态颅内压监测对行去骨瓣减压手术治疗重度高血压脑出血患者ADL分级的影响  

Effect of dynamic intracranial pressure monitoring on ADL grade in patients with severe hypertensive intracerebral hemorrhage undergoing bone flap decompression

作　　者：郭邦明[1] 廖文娟[1] 邱传珍[1] 刘鹏[1] GUO Bangming;LIAO Wenjuan;QIU Chuanzhen;LIU Peng(Department of Neurosurgery,the First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,334100,China)

机构地区：[1]赣南医学院第一附属医院神经外科,江西赣州334100

出　　处：《当代医学》2021年第36期37-39,共3页Contemporary Medicine

摘　　要：目的探讨重度高血压脑出血(HICH)行去骨瓣减压手术中采用动态颅内压监测对患者日常生活能力量表(ADL)分级的影响。方法回顾性分析2018年1月至2020年1月于本院行去骨瓣减压手术治疗的60例重度HICH患者的临床资料,根据干预方式不同分为对照组与观察组,每组30例。对照组给予常规颅内压监测,观察组给予动态颅内压监测。比较两组临床指标、并发症发生率、病死率及ADL分级。结果观察组甘露醇使用剂量低于对照组,住院时间及甘露醇使用时间均短于对照组(P<0.05);观察组并发症发生率为20.00%,低于对照组的46.67%,差异有统计学意义(P<0.05);两组病死率比较差异无统计学意义。观察组ADL分级优于对照组,差异有统计学意义(P<0.05)。结论重度HICH患者给予去骨瓣减压手术中采用动态颅内压监测的效果较好,可及时观察病情变化,减少甘露醇的使用剂量,并减少并发症发生,提升日常生活能力,值得临床推广应用。Objective To investigate the effect of dynamic intracranial pressure monitoring on the classification of activity of daily living(ADL)in patients with severe hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 60 patients with severe hich who underwent bone flap decompression in our hospital from January 2018 to January 2020 were retrospectively analyzed.They were divided into control group and observation group according to different intervention methods,with 30 cases in each group.The control group was given routine intracranial pressure monitoring,and the observation group was given dynamic intracranial pressure monitoring.The clinical indexes,complication rate,mortality and ADL grade were compared between the two groups.Results The dosage of mannitol in the observation group was lower than that in the control group,and the length of hospital stay and mannitol use time were shorter than those in the control group(P<0.05);the incidence of complications in the observation group was 20.00%,which was lower than 46.67% in the control group(P<0.05);there was no significant difference in mortality between the two groups.The ADL grade of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Conclusion Dynamic intracranial pressure monitoring is effective in severe hich patients undergoing bone flap decompression.It can timely observe the changes of the disease,reduce the dosage of mannitol,reduce complications and improve the ability of daily living,and it is worthy of clinical application.

关 键 词：重度高血压脑出血 动态颅内压监测 去骨瓣减压手术 并发症 

分 类 号：R651.12[医药卫生—外科学]