探讨小骨窗开颅血肿清除术联合有创颅内压监测技术指导高血压脑出血治疗的临床疗效

Clinical efficacy of small bone window craniotomy and hematoma removal combined with invasive intracranial pressure monitoring technology to guide the treatment of hypertensive cerebral hemorrhage

目的研究小骨窗开颅血肿清除术后行有创颅内压监测技术对高血压脑出血的治疗效果。方法 60例高血压脑出血患者,以抽签法分为对比组和观察组,各30例。对比组行小骨窗开颅血肿清除术治疗,观察组在小骨窗开颅血肿清除术后行有创颅内压监测技术指导。比较两组患者围术期指标、术后并发症发生情况、术后颅内压水平。结果观察组术后甘露醇用量及使用时间分别为(332.31±60.40)ml、(7.78±2.70)d,均优于对比组的(775.42±73.77)ml、(11.16±3.09)d,差异均具有统计学意义(P<0.05)。观察组术后并发症发生率为15.00%,低于对比组的46.67%,差异具有统计学意义(P<0.05)。观察组术后颅内压<20 mm Hg(1 mm Hg=0.133 kPa)患者比例为46.67%,高于对比组的20.00%,差异具有统计学意义(P<0.05)。结论高血压脑出血于小骨窗开颅血肿清除术后行有创颅内压监测技术指导,可避免血压波动,有效改善预后。

Objective To study the therapeutic effect of small bone window craniotomy and hematoma removal combined with invasive intracranial pressure monitoring technology to guide the treatment of hypertensive cerebral hemorrhage. Methods A total of 60 patients with hypertensive cerebral hemorrhage were divided into control group and observation group according to lottery method, with 30 cases in each group. The control group was treated with small bone window craniotomy and hematoma removal, and the observation group was treated with invasive intracranial pressure monitoring after small bone window craniotomy and hematoma removal. The perioperative indexes, postoperative complications and postoperative intracranial pressure were compared between the two groups. Results The mannitol dosage and usage time after operation of the observation group were(332.31±60.40) ml and(7.78±2.70) d, which were better than(775.42±73.77) ml and(11.16±3.09) d of the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications of the observation group was 15.00%, which was lower than 46.67% of the control group, and the difference was statistically significant(P<0.05). The proportion of postoperative intracranial pressure<20 mm Hg(1 mm Hg=0.133 kPa) of the observation group was 46.67%, which was higher than 20.00% of the control group, and the difference was statistically significant(P<0.05). Conclusion Technical guidance for invasive intracranial pressure monitoring after small bone window craniotomy for hematoma removal can avoid blood pressure fluctuations and effectively improve the prognosis of patients with hypertensive cerebral hemorrhage.