颅内压监测仪监测指导调整甘露醇剂量对重型颅脑损伤术后患者心肺功能及脱水效果的影响  

Influence of intracranial pressure monitor monitoring guidance of Mannitol dose adjustment on cardiopulmonary function and dehydration effect in patients after severe craniocerebral injury surgery

作　　者：童威 邵敏 夏克江 TONG Wei;SHAO Min;XIA Kejiang(Trauma Emergency Center,Yingtan City People's Hospital,Jiangxi Province,Yingtan 335000,China;Department of Surgery,Yingtan City People's Hospital,Jiangxi Province,Yingtan 335000,China)

机构地区：[1]江西省鹰潭市人民医院创伤急救中心,江西鹰潭335000 [2]江西省鹰潭市人民医院外科,江西鹰潭335000

出　　处：《中国当代医药》2023年第16期79-82,87,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202311823)。

摘　　要：目的探究颅内压监测仪监测指导调整甘露醇剂量对重型颅脑损伤术后患者心肺功能及脱水效果的影响。方法选取2020年1月至2022年6月鹰潭市人民医院收治的69例重型颅脑损伤术后患者作为研究对象,采用奇偶数分组法将其分为对照组(34例)和研究组(35例)。对照组采用CT复查结果和腰穿结果调整甘露醇剂量,研究组采用颅内压监测仪监测指导调整甘露醇剂量。比较两组心肺功能相关指标、并发症发生情况、脱水效果以及生存质量。结果研究组治疗前后的胸腔内血容量指数(ITBVI)、全身血管阻力指数(SVRI)、全心射血分数(GEF)、血管外肺水指数(EVLWI)和肺血管通透性(PVPI)比较,差异无统计学意义(P>0.05),对照组治疗后ITBVI、SVRI、PVPI低于本组治疗前,GEF高于本组治疗前,差异有统计学意义(P<0.05);研究组治疗后ITBVI、GEF、PVPI高于对照组,差异有统计学意义(P<0.05)。研究组治疗后脑水肿体积、颅内压小于对照组,差异有统计学意义(P<0.05);研究组治疗后肾功能损害、电解质紊乱、应激性溃疡、颅内感染发生率低于对照组,差异有统计学意义(P<0.05);研究组治疗后卡氏评分高于对照组,差异有统计学意义(P<0.05)。结论颅内压监测指导重型颅脑损伤术后应用甘露醇在保障脱水效果的同时,对患者心肺功能影响较小,并发症较少,且患者生存质量更高。Objective To explore the influence of intracranial pressure monitor monitoring guidance of Mannitol dose adjustment on cardiopulmonary function and dehydration effect in patients after severe craniocerebral injury surgery.Methods Sixty-nine patients after severe craniocerebral injury surgery who were admitted to Yingtan City People's Hospital from January 2020 to June 2022 were selected as the study subjects and were divided into control group(n=34)and study group(n=35)by means of the odd-even random grouping method.The control group adjusted Mannitol dose by CT review results and lumbar puncture results,and the study group adjusted Mannitol dose by monitoring guidance of intracranial pressure monitor.The related indicators of cardiopulmonary function,occurrence of complications,dehydration effect and quality of life were compared between the two groups.Results There were no significant differences in intrathoracic blood volume index(ITBVI),systemic vascular resistance index(SVRI),general ejection fraction(GEF),extravascular pulmonary water index(EVLWI)and pulmonary vascular permeability(PVPI)of the study group before and after treatment(P>0.05).After treatment,ITBVI,SVRI and PVPI of control group were lower than before,and GEF was higher than before,the differences were statistically significant(P<0.05).ITBVI,GEF and PVPI in the study group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).The volume of cerebral edema and intracranial pressure in the study group were lower than those in the control group after treatment,and the differences were statistically significant(P<0.05).The incidence of renal impairment,electrolyte disturbance,stress ulcer and intracranial infection in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The Kastler score of the study group was higher than that of the control group after treatment,and the difference was statistically significant(P<0.05).Co

关 键 词：颅内压监测 重型颅脑损伤 甘露醇 心肺功能 脱水效果 

分 类 号：R741[医药卫生—神经病学与精神病学]