颅内压监测在高血压脑出血穿刺引流术中的应用

Application of intracranial pressure monitoring in intracranial puncture and drainage in patients with hypertensive intracerebral hemorrhage

目的探讨颅内压(intracranial pressure,ICP)监测在微创穿刺外引流治疗高血压脑出血中的作用。方法收集2013-04~2017-04在该科住院行脑出血微创穿刺外引流治疗的97例患者,随机分为两组进行对比研究,观察组50例行ICP监测,对照组47例不行ICP监测,对两组术后并发症发生情况、术后6个月格拉斯哥预后量表(Glasco of score,GOS)进行评价。结果观察组患者术后GOS评级优于对照组(Z=-3.534,P=0.000);电解质紊乱、肺部感染、应激性溃疡、肾功能损害发生率均低于对照组,差异有统计学意义(P<0.05)。结论 ICP监测应用于高血压脑出血微创穿刺引流术安全有效,利于及时发现病情变化而调整治疗方案,对合理使用脱水剂、预防并发症、改善预后等方面均有积极意义。

Objective To explore the application of intracranial pressure（ICP） monitoring in intracranial puncture and drainage in patients with hypertensive intracerebral hemorrhage. Methods Ninety-seven patients with hypertensive cerebral hemorrhage received intracranial puncture and drainage in our department between April 2013 and April 2017. They were randomly divided into two groups： observation group（n=50）（receiving ICP monitoring） and control group（n=47）（receiving non-ICP monitoring）. The incidence of postoperative complications and Glasco of scores（GOS） were compared between the two groups 6 months after operation. Results GOS grading of the observation group was better than that of the control group 6 months after operation（P〈0.05）. Compared with those in the control group, the incidence rates of pneumonia, stress ulcer and renal dysfunction in the observation group were decreased significantly（P〈0.05）. Conclusion The use of ICP monitoring is safe and effective for intracranial puncture and drainage in the patients with hypertensive intracerebral hemorrhage.