不同床头抬高角度对重症颅脑损伤患者中心静脉压、颅内压的影响

Effects of different head elevation angles on central venous pressure and Intracranial Pressure in Patients with Severe Craniocerebral Injury

目的:分析不同床头抬高角度对重症颅脑损伤患者的中心静脉压(CVP)与颅内压(ICP)的影响。方法:选取2020年11月—2023年1月岑溪市人民医院重症医学科重症颅脑损伤患者30例为研究对象,待患者脱离急症期,使用ICP探头、床旁心电监护仪等检测患者的CVP、ICP水平。比较干预第1~7天床头抬高0°、15°、30°、45°时患者CVP、ICP。结果:第1~7天床头抬高45°时CVP水平比较,差异有统计学意义(P<0.05);第2~7天,床头抬高45°时CVP水平低于床头抬高0°、15°、30°时,差异有统计学意义(P<0.05)。第1~7天床头抬高45°时ICP水平比较,差异有统计学意义(P<0.05);第2~7天,床头抬高45°时ICP水平低于床头抬高0°、15°、30°时,差异有统计学意义(P<0.05)。结论:症颅脑损伤患者术后床头抬高45°能有效改善患者的CVP、ICP水平。

Objective:To analyze the effects of different bedside elevation angles on central venous pressure(CVP)and intracra-nial pressure(ICP)in patients with severe craniocerebral injury.Methods:Thirty patients with severe craniocerebral injury from the Department of Intensive Care of Cenxi People's Hospital from November 2020 to January 2023 were selected as the study sub-jects.ICP probe and bedside ECG monitor were used to detect the CVP and ICP levels of patients after they left the emergency pe-riod.CVP and ICP of patients with 0°,15°,30°and 45°elevation of head of bed were compared on the 1st to 7th day of interven-tion.Results:There was significant difference in CVP level between day 1 and day 7 when the head of the bed was raised by 45°(P<0.05);On days 2 to 7,the level of CVP at 45°head elevation was lower than that at 0°,15°and 30°head elevation,and the difference was statistically significant(P<0.05);There was significant difference in ICP level between day 1 and day 7 when the head of the bed was raised by 45°(P<0.05);On days 2 to 7,ICP level at 45°head elevation was lower than that at 0°,15°and 30°head elevation,and the difference was statistically significant(P<0.05).Conclusion:The elevation of the head of the bed by 45°can effectively improve the levels of CVP and ICP in patients with craniocerebral injury.