有创颅内压监测在半球性脑肿胀合并薄层硬膜下血肿术后的应用

摘要

目的：探讨有创颅内压监测在半球性脑肿胀合并薄层硬膜下血肿术后的应用价值。方法对56例半球性脑肿胀合并薄层硬膜下血肿术后按随机数字表法分为观察组（放置有创颅内压监测）及对照组（未放置颅内压监测），分别在预后、肾功能损害发生率方面进行对比分析。结果有创颅内压观察组预后良好率34．6％，对照组预后良好率30．0％，两组间差异无统计学意义（P ＞0．05）；观察组肾功能损害率26．9％，对照组肾功能损害率43．3％，两组间差异有统计学意义（P ＜0．05）。同时我们观察到术后颅内压持续高于25 mmHg 的患者多数预后不良。结论有创颅内压监测不能改善半球性脑肿胀合并薄层硬膜下血肿患者的预后，但可明显减少肾功能损害发生率，同时对患者预后判断有一定帮助。%Objective To investigate the value of sustained invasive intracranial pressure(ICP)monitoring in postoperative treatment of cerebral hemispheric swelling associated with subdural hematoma.Methods Fifty-six patients with cerebral hemispheric swelling asso-ciated with subdural hematoma were randomized into the treatment group (application of invasive ICP monitoring after operation,26 ca-ses)and control group (no ICP monitoring,30 cases).The prognosis and renal dysfunction were analyzed and compared between the two groups.Results There were 9 cases(34.6%)with good prognosis in invasive ICP monitoring group,and 9 cases(30.0%)with good prognosis in control group,respectively(P >0.05 ).There was no statistically significant difference between the two groups in terms of prognosis.Renal dysfunction occurred in 26.9% cases of the ICP monitoring group,and in 43.3% cases of the control group, respectively(P <0.05).There was statistically significant difference between the two groups in terms of the incidence of renal dysfunc-tion.We found that the 14 patients with intracranial pressure higher than 25 mmHg had a poor prognosis.Conclusions The use of ICP monitoring did not improve the prognosis of the patients with cerebral hemispheric swelling associated with subdural hematoma,but could reduce the incidence of renal failure,and may help to judge patients’prognosis.