出血性脑卒中术后颅内压监测及临床意义的研究

Clinical significance of intracranial pressure monitoring in patients after surgical intervention of cerebral hemorrhage

目的探讨持续动态颅内压（ICP）监测在出血性脑卒中术后治疗中的意义。方法对出血性脑卒中60例术后进行回顾性分析，随机分为监护组（30例）和对照组（30例）。监护组根据持续ICP的变化分为〈20mmHg、20—30mmHg、〉30mmHg，并随时调整治疗。对照组根据常规经验进行术后治疗。结果监护组ICP〉20mmHg者占60％，〉30mmHg者占20％。在甘露醇的应用和并发症发生率方面均低于对照组，两组差异有统计学意义（P〈0.01和P〈0．05）。预后情况监护组优于对照组（P〈0．05），且不同ICP之间预后差异有统计学意义（P〈0．05）。结论对于出血性脑卒中术后患者进行ICP监护有利于指导和及时调整治疗方案，减少并发症，改善预后。

Objective To investigate the clinical significance of intracranial pressure（ ICP） monitoring in patients after surgical treatment of cerebral hemorrhage. Methods The postoperative data of 60 patients with cerebral hemorrhage were retrospectively analyzed. The patients were divided randomly into monitoring group（ n = 30） and control group（ n = 30）. The monitoring group was subjected to continuousl ICP monitoring and received appropriate treatment according to different ICP of 〈 20 mmHg,20 - 30 mmHg and 〉 30 mmHg, while the control group was treated by conventional postoperative method. Results ICP was 〉 20 mmHg in 60% of and 〉 30 mmHg in 20% of the monitored patients. The dosages of mannitol and the incidence of complications were all lower in monitored group than in control group, with significant differences between the two groups（ P 〈 0.01 and P 〈 0.05） ; the prognosis in monitored group was better than that in control group（ P 〈 0.05 ）, There were significant differences in prognosis between different brackets of ICP（ P 〈 0.05 ）. Conclusions ICP monitoring should be carried out as timely as possible to patients after surgical intenvention of cerebral hemorrhage in order to reduce the incidence of complications and improve the prognosis.