持续颅内压监测下指导甘露醇应用在高血压脑出血患者开颅血肿清除术后的应用效果  

Application effect of mannitol guided by continuous intracranial pressure monitoring in patients with hypertensive intracerebral hemorrhage after removal of craniotomy hematoma

作　　者：康寿磊[1] 王玉娟 李金秀[1] KANG Shoulei;WANG Yujuan;LI Jinxiu(Department of Critical Care Medicine,the Liaocheng Second Affiliated Hospital of Shandong First Medical University,the Second People's Hospital of Liaocheng,Shandong Province,Linqing252600,China;Department of Cancer,the Liaocheng Second Affiliated Hospital of Shandong First Medical University,the Second People's Hospital of Liaocheng,Shandong Province,Linqing252600,China)

机构地区：[1]山东省第一医科大学附属聊城二院,聊城市第二人民医院重症医学科,山东临清252600 [2]山东省第一医科大学附属聊城二院,聊城市第二人民医院肿瘤科,山东临清252600

出　　处：《中国当代医药》2025年第5期66-70,共5页China Modern Medicine

基　　金：山东省医药卫生科技发展计划项目(202013011262)。

摘　　要：目的探究持续颅内压(ICP)监测下指导甘露醇应用在高血压脑出血患者开颅血肿清除术后的应用效果。方法选取2022年1月至2023年12月聊城市第二人民医院收治的80例高血压脑出血患者作为研究对象,按照随机数字表法将其分为对照组和观察组,每组各40例。两组患者均行开颅血肿清除手术治疗高血压脑出血,对照组给予术后常规治疗,观察组使用持续ICP监测下指导甘露醇应用治疗。比较两组患者治疗期指标、预后情况、血清应激反应[降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、中性粒细胞占比(NEUT)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)],以及并发症发生率。结果观察组的脑血肿量、甘露醇使用量少于对照组,甘露醇减量时间和住院时间短于对照组,差异有统计学意义(P<0.05);观察组的预后效果优于对照组,差异有统计学意义(P<0.05);观察组的PCT、hs-CRP、NEUT低于对照组,差异有统计学意义(P<0.05);观察组的NIHSS评分和并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血患者在持续ICP监测下指导甘露醇应用效果显著,并发症发生率较低,利于改善患者神经功能,消除脑血肿,降低甘露醇使用量,缩短甘露醇减量时间,改善患者应激反应,且预后效果较好,安全可靠,具有广泛应用前景。Objective To investigate the application effect of mannitol guided by continuous intracranial pressure(ICP)monitoring in patients with hypertensive intracerebral hemorrhage after craniotomy hematoma removal.Methods A total of 80 patients with hypertensive cerebral hemorrhage admitted to the Second People's Hospital of Liaocheng from January 2022 to December 2023 were selected as the study objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.Patients in both groups received craniotomy hematoma removal surgery to treat hypertensive intracerebral hemorrhage,the control group received routine postoperative treatment,and the observation group was treated with mannitol guided by continuous ICP monitoring.The treatment period indexes,prognosis,serum stress response(procalcitonin[PCT],hypersensitive C-reactive protein[hs-CRP],neutrophil proportion[NEUT]),neurological function(National Institutes of Health stroke scale[NIHSS])and complication rate of the two groups were compared.Results The amount of cerebral hematoma and the consumption of mannitol in the observation group were less than those in the control group,and the duration of mannitol reduction and hospitalization were shorter than those in the control group,the differences were statistically significant(P<0.05).The prognosis effect of observation group was better than control group,the difference was statistically significant(P<0.05).The PCT,hs-CRP and NEUT in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The NIHSS score and the total complication rate of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The application of mannitol in hypertensive intracerebral hemorrhage patients under continuous ICP monitoring has significant effects and a low incidence of complications,which is conducive to improving the neurological funct

关 键 词：高血压脑出血 持续颅内压监测 甘露醇 并发症 

分 类 号：R651[医药卫生—外科学]