持续颅内压监测在高血压性脑出血治疗中的应用

Application of continuous intracranial pressure monitoring in the treatment of hypertensive intracerebral hemorrhage

目的探讨分析持续颅内压监测在高血压性脑出血治疗中的应用效果。方法选择2014年10月~2016年10月我院收治的高血压性脑出血患者34例,按入院时间顺序分为两组,观察组16例,对照组18例,两组患者均给予血肿钻孔外引流术,观察组同时置入颅内压监测系统,进行持续颅内压监测,比较两组甘露醇使用量、并发症发生率及NIHSS评分。结果观察组各时间点甘露醇用量均少于对照组(P<0.05),观察组总使用量[(1301.64±121.71)ml]显著少于对照组的[(1848.92±89.93)ml],两组比较差异有极显著性(P<0.01);两组治疗前NIHSS评分比较差异无统计学意义(P>0.05);治疗后与治疗前相比两组NIHSS评分均有显著下降,且观察组治疗后NIHSS评分与对照组相比下降较快,差异有统计学意义(P<0.05);观察组并发症总发生率为25.00%,对照组为88.89%,两组比较差异有统计学意义(P<0.05)。结论持续颅内压监测可有效控制高血压脑出血患者甘露醇的使用量,对缩短疗程及降低并发症发生率均起到重要促进作用,值得临床应用推广。

Objective To investigate the effect of application of continuous intracranial pressure monitoring in the treatmere of hypertensive intracerebral hemorrhage.Methods Altogether 34 cases of hypertensive intracerebral hemorrhage patients who were treated in our hospital from October 2014 to October 2016 were divided into two groups according to the time sequence of admission：16 cases in observation group and 18 cases in control group;two groups of patients were treated with hematoma drilling external drainage;at the meanwhile, observation group was implanted with the intracranial pressure monitoring system for continuous monitoring of intracranial pressure.The mannitol dosage,the incidence of complications and NIHSS（the National Institutes of Health Stroke Scale）score of two groups were compared.Results The mannitol dosage of observation group at different time points was less than that of control group （P〈0.05）;the total man- nitol dosage of observation group [（1301.64±121.71） ml] was significantly less than that of control group [（1848.92± 89.93） ml],with statistical significant difference between the two groups （P〈0.01）;no statistically significant difference was seen in pre-treatment NIHSS score between the two groups （P〉0.05）;the pre-and post-treatment NIHSS score of two groups was decreased significantly,and the post-treatment NIHSS score of observation group was decreased more significantly than that of control group,with statistically significant difference （P〈0.05）;the total incidence of complications of observation group was 25.00% versus control group＇s 88.89%,with statistically significant difference （P〈0.05）. Conclusion Continuous intraeranial pressure monitoring can effectively control the use of mannitol in patients with hypertensive intracerebral hemorrhage,and play an important role in shortening the course of treatment and reducing the incidence of complications,which is worthy of clinical application and promotion.