脑室型传感器置入颅内压监测对急性大面积脑梗死治疗决策和预后的影响  

Effect of intracranial pressure monitoring with ventricular sensor on treatment decision and prognosis of acute massive cerebral infarction

作　　者：陆文丽 汪慧娟 LU Wen-li;WANG Hui-juan(Department of Neurosurgery,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《川北医学院学报》2022年第4期524-527,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨脑室型传感器置入颅内压(ICP)监测对急性大面积脑梗死治疗决策和预后的影响。方法:按照治疗方式的不同将79例急性大面积脑梗死患者分为研究组(n=42)和对照组(n=37)。研究组接受急诊脑室型传感器置入术进行ICP监测,并依据ICP监测情况指导降ICP治疗和判断手术时机;对照组未接受有创ICP监测,依据影像学和临床症状等情况判断手术时机。比较两组治疗方式、甘露醇使用情况、住院时间以及预后恢复等指标。结果:对照组保守治疗12例,手术治疗25例。研究组保守治疗15例,手术治疗27例。研究组甘露醇使用次数、甘露醇日均使用量和住院时间低于对照组,6个月预后良好率、Barthel指数高于对照组(P<0.05)。研究组手术治疗者甘露醇使用次数、甘露醇日均使用量和住院时间也低于对照组,6个月Barthel指数高于对照组(P<0.05);两组手术治疗者6个月预后良好率比较,差异无计学意义(P>0.05)。结论:急性大面积脑梗死患者接受脑室型传感器置入ICP监测,有助于合理降ICP和判断手术治疗时机,缩短住院时间,改善近期预后和生活自理能力。Objective:To investigate the effect of intracranial pressure(ICP)monitoring with ventricular sensor on the treatment decision and prognosis of acute massive cerebral infarction.Methods:79 patients with acute massive cerebral infarction wereivided into study group(n=42)and control group(n=37)according to different treatment methods.The study group received emergency ventricular sensor implantation for ICP monitoring,and guided ICP reduction treatment and judged the operation time according to the ICP monitoring.The control group did not receive invasive ICP monitoring,the operation time was judged according to imaging and clinical symptoms.The treatment mode,mannitol use,hospital stay and prognosis were compared between the two groups.Results:In the control group,12 cases were treated conservatively and 25 cases were treated surgically.In the study group,15 cases were treated conservatively and 27 cases were treated surgically.The times of mannitol use,average daily mannitol use and length of hospital stay in the study group were lower than those in the control group,and the 6-month good prognosis rate and Barthel index were higher than those in the control group(P<0.05).Comparison of surgical treatment between the two groups,the times of mannitol use,average daily mannitol use and hospital stay in the study group were lower than those in the control group,and the Barthel index at 6 months was higher than that in the control group(P<0.05).There was no statistically significant difference in the 6-month good prognosis between the two groups(P>0.05).Conclusion:ICP monitoring with ventricular sensor in patients with acute massive cerebral infarction is helpful to reduce ICP reasonably,judge the timing of surgical treatment,shorten the length of hospital stay,and improve the short-term prognosis and self-care ability.

关 键 词：急性大面积脑梗死 脑室型传感器 颅内压 治疗决策 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]