颅内压监测对神经系统重症患者组织灌注和预后的影响  

Effect of intracranial pressure monitoring on tissue perfusion and prognosis in critically ill patients with nervous system

作　　者：杨幸达 故友珠 邹志斌 朱红 钟波 俞大林 YANG Xingda;GU Youzhu;ZOU Zhibin;ZHU Hong;ZHONG Bo;YU Dalin(Department of Neurosurgery,Xinyu People′s Hospital,Jiangxi Province,Xinyu338000,China)

机构地区：[1]江西省新余市人民医院神经外科,江西新余338000

出　　处：《中国当代医药》2022年第25期97-100,共4页China Modern Medicine

基　　金：江西省新余市科技计划项目(20213090834)。

摘　　要：目的探讨持续性颅内压(ICP)监测对神经系统重症患者组织灌注及预后的影响。方法选取2019年2月至2021年2月新余市人民医院神经外科收治的60例神经系统重症患者作为研究对象,按抽签法分为监测组(30例)和对照组(30例),对照组采用常规监测ICP,监测组采用持续性ICP监测,比较两组患者的脑灌注压(CPP)、格拉斯哥昏迷量表(GCS)评分,并发症及预后结局等情况。结果两组监测后的ICP均低于监测前,CPP均高于监测前,差异有统计学意义(P<0.05);监测组监测后的ICP低于对照组,CPP高于对照组,差异有统计学意义(P<0.05);监测后,两组的睁眼反应、语言反应、肢体运动评分均高于监测前,且监测组高于对照组,差异有统计学意义(P<0.05);监测组的预后分级优于对照组,差异有统计学意义(P<0.05);两组的并发症比较,差异无统计学意义(P>0.05)。结论对神经系统重症患者持续ICP监测,有利于临床疗效的提高,加强患者脑组织灌注,改善患者的预后,一定程度上减少并发症的发病率。Objective To explore the application effects of continuous intracranial pressure(ICP)monitoring and nursing intervention in tissue perfusion of patients with severe neurological diseases.Methods A total of 60 patients with severe nervous system diseases treated in Department of Neurosurgery of Xinyu People′s Hospital were selected as research subjects from February 2019 to February 2021.They were divided into the monitoring group(n=30)and the control group(n=30)by drawing lots.The control group received routine nursing,while the monitoring group took continuous ICP monitoring nursing intervention.ICP,cerebral perfusion pressure(CPP),Glasgow coma scale(GCS)scores,complications and prognosis were compared between the two groups before and after nursing.Results After monitoring,the ICP in two groups was lower than that before monitoring,while the CPP was higher than that before monitoring,with statistically significant differences(P<0.05).After monitoring,the ICP in the monitoring group was lower than that in the control group,while the CPP was higher than that in the control group,with statistically significant differences(P<0.05).After monitoring,the scores of eye opening response,language response and limb movement in two groups were higher than those before monitoring,and the scores of those in the monitoring group were higher than those in the control group,with statistically significant differences(P<0.05).The prognosis grade of the monitoring group was better than that of the control group,and the difference was statistically significant(P<0.05).There was no statistical difference in the complications between the two groups(P>0.05).Conclusion Continuous ICP monitoring of patients with severe nervous system diseases is beneficial to promoting the clinical efficacy,enhancing the cerebral tissue perfusion,improving the prognosis and reducing the incidence rates of complications to a certain extent.

关 键 词：神经系统 持续性颅内压监测 组织灌注 预后影响 

分 类 号：R741.05[医药卫生—神经病学与精神病学]