脑室出血的综合治疗应用价值分析

Analysis the Therapeutic Value of Intraventricular Hemorrhage

目的:探讨高血压性脑室铸型出血、脑灌注压,颅内压监测在老年高血压脑出血患者救治中的应用价值。方法:对118例老年高血压脑室铸型出血患者(监测组)在保证脑灌注压(CPP)9.31～12kPa条件下持续颅内压(ICP)及平均动脉压(MAP)监测,并在保持ICP 0.8～2kPa情况下,对双侧脑室铸型出血行双侧脑室置管外引流并持续冲洗加术后腰穿脑脊液置换术。对98例老年高血压脑室铸型出血患者(对照组)持续血压监测,控制血压于发病前水平或低于入院水平20%,对比两组患者治疗效果,同时评价保证脑灌注压条件下颅内压监测在老年高血压脑出血救治中的应用价值。结果:监测组死亡率5.1%(6/118)低于对照组死亡率18.3%(18/98),两组比较差异有统计学意义(P<0.05),监测组治疗有效率83.9%(99/118)高于对照组有效率52%(51/98),两组比较差异有统计学意义(P<0.05)。结论:保证脑灌注压条件下颅内压监测下血压控制可改善老年高血压脑出血患者预后。

Objective：To discuss the application value of monitoring intracranial pressure,cerebral perfusion pressure in curing of hypertensive cerebral hemorrhage in the elderly.Methods：The treatment for 118 elder hypertensive cerebral hemorrhage patients in monitoring group was to monitor intracranial pressure continuously with ensuring cerebral perfusion pressure of 9.31~12kpa and control blood pressure by keeping intracranial pressure of 0.8~2kpa.98 elder cases with hypertensive cerebral hemorrhage in control group were given continuous blood pressure monitoring.The blood pressure was controlled for the level of prodrome or 20% lower than entering hospital.The therapeutic effects of two groups were contrasted to evaluate Application Value of Monitoring Intracranial Pressure with Ensuring Cerebral Perfusion Pressure in Controlling Blood Pressure of Hypertensive Cerebral Hemorrhage in the Elderly.Results：The mortality and efficiency of monitoring group and control group were 5.1%,18.3% and 83.9%,52% respectively.Both mortality and efficiency of two groups have significant difference（P0.05）.Conclusion：The treatment of monitoring intracranial pressure with ensuring cerebral perfusion pressure in controlling blood pressure can improve the prognosis of elder hypertensive cerebral hemorrhage patients.