神经重症患者应用无创颅内压监测的效果  

Effect of noninvasive intracranial pressure monitoring in patients with severe neurologicalconditions

作　　者：王聪梅 齐路 刘瑞芳 孔静波 宋瑞捧 陈清亮 WANG Congmei;QI Lu;LIU Ruifang;KONG Jingbo;SONG Ruipeng;CHEN Qingliang(The Third People’s Hospital of Henan Province,Zhengzhou 450006,China)

机构地区：[1]河南省直第三人民医院,河南郑州450006

出　　处：《中国实用神经疾病杂志》2023年第7期871-874,共4页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20210255)。

摘　　要：目的 分析神经重症患者应用无创颅内压(ICP)监测的效果。方法 选取2019-02—2022-02河南省直第三人民医院神经重症患者121例为研究对象,随机分为对照组(n=60例)和研究组(n=61例),其中对照组给予有创ICP监测,研究组给予无创ICP监测,对比2组预后、ICP变化、甘露醇使用量和使用时间、肾功能损伤,以及并发症情况。结果 研究组预后良好率70.49%高于对照组的51.67%(P<0.05);2组手术第1、3、5、7天的ICP值比较差异无统计学意义(P>0.05);研究组甘露醇使用量和使用时间均较对照组小(P<0.05),研究组肾功能损伤率6.56%低于对照组的21.67%(P<0.05);研究组并发症发生率4.92%低于对照组的20.00%(P<0.05)。结论 无创ICP监测应用于神经重症患者,其准确率和有创ICP监测差别不大,不仅可增加预后良好率,减少肾损伤和脱水剂的使用,还可减少并发症。Objective To investigate the clinical analysis of non-invasive intracranial pressure(ICP)monitoring in critically ill neurological patients.Methods A total of 121 patients with severe neurological disease in our hospital from February 2019 to February 2022 were selected as the research objects and randomly divided into the control group(60 cases)and the study group(61 cases),of which the control group was given invasive ICP monitoring,the study group was given non-invasive ICP monitoring,and the prognosis,ICP changes,mannitol dosage,renal function damage,and complications were compared and analyzed between the two groups.Results In terms of prognosis,the good prognosis rate of the study group was 70.49%higher than that of the control group(51.67%)(P<0.05).There was no significant difference in the ICP values between the two groups on the 1st,3rd,5th,and 7th days of operation(P>0.05).The dosage and duration of mannitol in the study group were smaller than those in the control group(P<0.05).In terms of renal function damage,the injury rate of the study group(6.56%)was lower than that of the control group(21.67%)(P<0.05).The incidence of complications in the study group(4.92%)was lower than that in the control group(20.00%)(P<0.05).Conclusion The accuracy of non-invasive ICP monitoring is not much different from that of invasive ICP monitoring when applied to critically ill neurological patients.It can not only increase the rate of good prognosis,and reduce kidney damage and the usage of dehydrating agents,but also reduce complications.

关 键 词：神经重症 无创颅内压监测 甘露醇 肾损伤 预后 

分 类 号：R651[医药卫生—外科学]