中重度颅脑损伤颅内压波幅监测与甘露醇应用的关系及预后情况研究  

Study on the relationship between intracranial pressure amplitude monitoring and mannitol application in moderate to severe craniocerebral injuries and prognostic situation

作　　者：李松林[1] 张志伟 蒋令修[1] LI Songlin;ZHANG Zhiwei;JIANG Lingxiu(Department of Neurosurgery Intensive Care Unit,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院神经重症科,河南开封475000

出　　处：《宁夏医学杂志》2024年第3期215-218,共4页Ningxia Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200554)。

摘　　要：目的探究中重度颅脑损伤患者颅内压波幅监测与甘露醇应用的关系及患者预后情况。方法选取中重度颅脑损伤患者80例,按随机数字表法将其分为2组,实验组和对照组,每组40例。对照组采用单纯监测颅内压,若患者单纯监测颅内压>22 mmHg则应用甘露醇,观察组采用平均颅内压波幅监测,若患者平均颅内压波幅(MWA)>5 mmHg则应用甘露醇。观察2组甘露醇应用总量、甘露醇应用时间、甘露醇相关并发症发生率及治疗后3个月预后情况。结果2组患者性别、年龄、格拉斯哥昏迷评分法(GCS)评分、损伤原因、出血部位等一般资料比较,差异无统计学意义(P>0.05)。观察组甘露醇应用总量、甘露醇应用时间均低于对照组,差异有统计学意义(P<0.05)。2组患者在急性肾衰竭、血容量不足、心律失常等并发症比较上,差异无统计学意义(P>0.05),但在高渗状态、电解质紊乱、静脉炎等并发症发生率上,观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组预后良好率为75.00%,显著高于对照组的52.50%,差异有统计学意义(P<0.05)。结论中重度颅脑损伤患者采用平均颅内压波幅(MWA)监测并应用甘露醇治疗,在减少甘露醇应用总量、应用时间和甘露醇相关并发症的同时,可以提高预后良好率,具有一定的临床应用价值。Objective To explore the relationship between the monitoring of intracranial pressure amplitude and the application of mannitol and the prognosis of patients with moderate to severe craniocerebral injury.Methods A total of 80 patients with moderate to severe craniocerebral injury were selected and the patients were divided into two experimental group and control group.The control group was monitored solely by intracranial pressure monitoring,and mannitol was applied for patients with simple monitoring of intracranial pressure>22 mmHg,while the observation group was monitored for mean intracranial pressure amplitude,and mannitol was applied for patients with mean intracranial pressure amplitude(MWA)>5 mmHg.The total amount of mannitol,the duration of mannitol application,the incidence of mannitol-related complications,and the prognosis at three months after treatment were observed in the two groups.Results There was no statistically significant difference between the two groups in the comparison of general information such as gender,age,Glasgow Coma Scale(GCS)score,causes of injury,and site of hemorrhage(P>0.05).The total amount of mannitol application and the time of mannitol application in the observation group were lower than those in control group,and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in acute renal failure,hypovolemia,arrhythmia and other complications(P>0.05),but the incidence of hypertonic state,electrolyte disturbance,phlebitis and other complications in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The good prognosis rate of observation group was 75.00%significantly higher than that of control group 52.50%,and the difference was statistically significant(P<0.05).Conclusion The mean intracranial pressure amplitude(MWA)monitoring and treatment of mannitol in patients with moderate and severe craniocerebral injuries can improve the rate of good prog

关 键 词：颅内压波幅监测 甘露醇 预后 并发症 

分 类 号：R651.15[医药卫生—外科学]