高血压脑出血患者应用持续颅内压监测的临床意义

Exploration of continuously monitoring intracranial pressure applied to hypertensive cerebral hemorrhage

目的探讨使用颅内压监测仪持续观察高血压脑出血患者颅内压变化的意义。方法随机选取2014-04—2015-04在我院进行治疗的高血压脑出血患者62例,利用随机数表法分为实验组与对照组,每组31例,入院后2组均行常规基础治疗,包括营养神经、预防感染、维持水盐代谢平衡等。对照组常规使用甘露醇,实验组依据颅内压监测仪观察数值变化及时调整甘露醇用量及治疗方案。治疗结束后比较2组甘露醇使用量、电解质紊乱发生率、肾功能损害率、肺部感染及脑出血复发率以及血压控制情况。结果实验组甘露醇使用明显少于对照组,差异有统计学意义(P<0.05)。实验组电解质紊乱发生率、肾功能损害率、肺部感染及脑出血复发率均少于对照组,差异有统计学意义(P<0.05)。实验组能较好控制血压。结论持续颅内压监测能够指导临床高血压脑出血患者脱水降压剂的使用,降低并发症的发生,改善预后,对生化指标的稳定有较为肯定的意义,且安全有效。

Objective To explore the clinical significance of continuously monitoring intracranial pressure on hyperten-sive cerebral hemorrhage（HCH）.Methods According to random digital table method,all of 62 HCH cases treated in our hos-pital from April 2014 to April 201 5 were divide into experimental group and control group,31 cases in each group.Besides rou-tine therapy including nurturing nerve,preventing injection and balancing water-electrolyte metabolism,the control group was treated by mannitol,which was modulated based on the results of continuously monitoring intracranial pressure in the experi-mental group.After terminal of treatment,the usage amount of mannitol,incidences of electrolyte disturbance,renal dysfunc-tion and pulmonary infection,the recurrence rate of cerebral hemorrhage and blood pressure control in the two groups were compared.Result The usage amount of mannitol in the experimental group was significantly less than that in the control group,the difference was statistically significant（P 〈0.05）.Compared with the control group,the experimental group showed lower incidences of electrolyte disturbance,renal dysfunction,pulmonary infection and lower recurrence rate of cerebral hemor-rhage,all the differences were significant（P 〈0.05）.The experimental group could control blood pressure better.Conclusion Continuous intracranial pressure monitoring can guide the usage amount of dehydrant,reduce the incidence of complications and improve the prognosis and have a certain effect on the stability of biochemical indices in hypertensive cerebral hemorrhage pa-tients with safety.