颅内压监测在中等量高血压脑出血治疗中的应用

摘要

目的 探讨颅内压监测(ICP)在中等量高血压脑出血手术方式选择及术后脱水治疗中的应用价值.方法 随机选取64例中等量高血压脑出血患者,分为监护组(33例)和对照组(31例).监护组根据患者临床表现、CT检查,结合ICP决定手术方式,对照组根据患者临床表现及CT检查决定手术方式.监护组根据ICP结合头颅CT使用脱水剂,对照组根据临床经验结合头颅CT使用脱水剂.统计比较两组患者的手术方式、术后并发症及预后.结果 颅内压监护组的去骨瓣手术率、二次手术率、肾功能损害及内环境紊乱的发生率均低于对照组(P＜0.05),6个月后的GOS评分高于对照组(P＜0.05).结论 颅内压监测对中等量高血压脑出血的手术方式选择能提供很好的指导意义,能减少术后并发症的发生,对患者预后有很大帮助.%Objective The application value of intracranial pressure monitoring (ICP) in selection of operative methods and post-operative dehydration treatment of patients with moderate hypertensive intracerebral hemorrhage were studied.Methods Sixty-four patients with moderate hypertensive intracerebral hemorrhage were selected randomly and then were divided into intracranial pressure monitoring group (n=33) and control group (n =31).The method of operation was chosen according to clinical manifestation and CT of patients in both two groups,however,ICP value of patients in intracranial pressure monitoring group was another important factor which needed to be concerned.In addition,dehydrating agents were used according to ICP value and the result of CT of patients in intracranial pressure monitoring group,but those were used according to clinical experience of doctors and the result of CT of patients in control group.Finally,the operative methods,post-operative complications and prognosis were compared between two groups.Results The rates of decompressive craniectomy,re-operation,renal damage and internal environment disturbance in intracranial pressure monitoring group were significantly lower than those in the control group (P ＜ 0.05).Six months after intracerebral hemorrhage,GOS was used to assess the prognosis of patients and we found GOS in intracranial pressure monitoring group was markedly higher than that in the control group (P ＜ 0.05).Conclusion Intracranial pressure monitoring plays an important guiding role in selection of operative methods of patients with moderate hypertensive intracerebral hemorrhage and it reduces the occurrence of post-operative complications,which are helpful for prognosis of patients with intracerebral hemorrhage.