体位对神经内科危重症患者颅内脑灌注压的影响

Effect of Position on the Encephalic Cerebral Perfusion Pressure of Critically Ill Patients in the Department of Neurology

目的探讨体位对神经内科危重症患者颅内脑灌注压的影响。方法方便选取2015年1—12月在聊城市复退军人医院神经内科住院的55例危重症患者进行观察,所有患者均通过传感器对颅内压力进行测定,分析床头抬高不同高度后患者颅内灌注压。结果通过测定发现,患者床头抬高0、10、20、30°和40°时其平均动脉压和颅内脑灌注压具有一定程度改变,其中抬高床头0~40°时患者颅内压、脑灌注压以及平均动脉压差异有统计学意义,30°和40°脑内灌注压[(74.8±3.2)mmHg vs(62.6±3.1)mmHg]比较差异有统计学意义(P<0.05)。结论体位变化对神经内科危重症患者具有十分重要的影响,将床头抬高30°时能有效降低患者颅内压以及低血压发生率。

Objective To discuss the effect of position on the encephalic cerebral perfusion pressure of critically ill patients in the department of neurology.Methods 55 cases of critically ill patients in our hospital from January to December 2015 were convenient selected and the encephalic pressure of all patients was measured by the sensor,and the encephalic cerebral perfusion pressure of patients after the bed head elevation in different heights was analyzed.Results The measurement showed that the mean arterial pressure and encephalic cerebral perfusion pressure of patients after the bed head elevation of 0,10,20,30° and 40°had a certain change,and there were differences in the intracranial pressure,cerebral perfusion pressure and mean arterial pressure of patients at the time of bed head elevation of 0-40,and the difference in the encephalic cerebral perfusion pressure at 30° and 40° had statistical significance [（74.8±3.2）mmHg vs（62.6 ±3.1）mmHg]（P〈0.05）.Conclusion Body position has a very important effect on critically ill patients in the department of neurology,and the bed head elevation of 30°can effectively reduce the incidence rate of intracranial pressure and hypopiesis.