颅内压监测对重症高血压性脑出血患者术后临床疗效、神经功能及药物用量影响

Effect of intracranial pressure monitoring on the clinical efficacy, neurological function and drug dosage in patients with severe hypertensive cerebral hemorrhage

目的探讨颅内压(ICP)监测对重症高血压性脑出血患者术后临床疗效、神经功能及药物用量影响。方法将86例重症高血压性脑出血患者按照随机数字表法分为观察组和对照组,每组43例,均行颅血肿清除术。对照组给予术后常规监护,观察组加用ICP监测,比较两组患者的治疗效果、神经功能和脱水药物用量。结果治疗3个月后观察组总有效率为67.44%,对照组为39.53%,两组比较差异有统计学意义(P<0.05);观察组术后1周内平均甘露醇用量为(781±76)g,术后1周ICP为(1.72±0.23)kPa,均显著低于对照组,差异有统计学意义(P<0.05);术后1周两组患者的神经功能缺损评分均低于术前,观察组为(13.3±2.2)分,低于对照组,差异有统计学意义(P<0.05);观察组术后电解质紊乱、肾功能损害发生率为9.30%、4.65%,均低于对照组,差异有统计学意义(P<0.05);对照组术后1周血尿素氮及24 h尿蛋白水平均低于观察组,差异均有统计学意义(P<0.05)。结论通过实施ICP监测可以显著改善患者预后,减少脱水药物用量,减轻对患者神经功能损伤,具有较高的临床价值。

Objective To investigate the effect of intracranial pressure monitoring on the clinical efficacy, neurological function and drug dosage in patients with severe hypertensive cerebral hemorrhage. Methods 86 cases of severe hypertensive cerebral hemorrhage were randomly divided into observation group and control group with 43 cases in each group, underwent cranial hematoma. The control group was given routine postoperative care, while observation group were being treated with intracranial pressure monitoring. Therapeutic effect,nerve function and dehydration drug dosage of two groups were compared. Results After 3 months of treatment in observation group, the total effective rate was 67.44%, 39.53%in the control group, there was significant difference between two groups（P〈0.05）;observation group after one week per capita mannitol dosage is（781±76）g, one weeks after operation, ICP was（1.72±0.23）kPa, were significantly lower than the control group, the difference is statistically significant（P〈0.05）;postoperative neurological function deficit score one weeks in patients of the two groups were lower than those before operation, the observation group was（13.3±2.2）, lower than that of the control group, the difference was statistically significant（P〈0.05）;The observation group and electrolyte disorders, kidney function damage rate was 9.30%, 4.65%, was lower than the control group, the difference was statistically significant（P〈0.05）;the control group after 1 weeks, blood urea nitrogen and 24 h urinary protein levels were lower than those in the observation group, the differences were statistically significant（P 〈 0.05）.Conclusion The implementation of ICP monitoring can significantly improve the prognosis of patients, reduce the dehydration drug dosage, reduce the neurological damage, and have a high clinical value.