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中华神经创伤外科电子杂志 ›› 2018, Vol. 04 ›› Issue (04) : 209 -212. doi: 10.3877/cma.j.issn.2095-9141.2018.04.005

所属专题: 文献

临床研究

颅内压监测联合镇静镇痛治疗高血压脑出血破入脑室的疗效分析
武孝刚1, 王金标1, 许少年1, 袁杰1, 张永明1,()   
  1. 1. 230031 合肥,解放军第一五医院神经外科
  • 收稿日期:2018-03-11 出版日期:2018-08-15
  • 通信作者: 张永明
  • 基金资助:
    2014年南京军区医学科技创新重点课题(14ZD17)

Clinical analysis of intracranial pressure monitoring combined with sedation and analgesia in treating hypertensive intracerebral hemorrhage broken into ventricles

Xiaogang Wu1, Jinbiao Wang1, Shaonian Xu1, Jie Yuan1, Yongming Zhang1,()   

  1. 1. Department of Neurosurgery, The No.105 Hospital of PLA, Hefei 230031, China
  • Received:2018-03-11 Published:2018-08-15
  • Corresponding author: Yongming Zhang
  • About author:
    Corresponding author: Zhang Yongming, Email:
引用本文:

武孝刚, 王金标, 许少年, 袁杰, 张永明. 颅内压监测联合镇静镇痛治疗高血压脑出血破入脑室的疗效分析[J/OL]. 中华神经创伤外科电子杂志, 2018, 04(04): 209-212.

Xiaogang Wu, Jinbiao Wang, Shaonian Xu, Jie Yuan, Yongming Zhang. Clinical analysis of intracranial pressure monitoring combined with sedation and analgesia in treating hypertensive intracerebral hemorrhage broken into ventricles[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2018, 04(04): 209-212.

目的

分析动态颅内压监测联合镇静镇痛治疗高血压脑出血破入脑室的疗效。

方法

回顾性分析解放军第一五医院神经外科自2015年1月至2017年12月收治的169例高血压脑出血破入脑室同时行侧脑室外引流术患者的临床资料,其中颅内压监测联合镇静镇痛治疗患者57例(监测治疗组)、镇静镇痛治疗患者69例(治疗组)和对照组43例。所有病例均随访6个月,比较各组神经功能缺损程度、GCS评分、GOS评分及NICU入住时间以及甘露醇使用等情况。

结果

监测治疗组1月及6月神经功能缺损评分、GCS评分、GOS评分及NICU入住时间等均显著优于治疗组和对照组,且甘露醇使用量、肾功能损害及电解质紊乱发生率等均显著减少,差异具有统计学意义(P<0.05)。

结论

持续颅内压监测可动态把握高血压脑出血破入脑室颅内压变化情况,能够避免脱水剂的过度使用,改善预后,同时联合镇静镇痛治疗效果更显著,适合临床推广应用。

Objective

To evaluate clinical analysis of intracranial pressure monitoring combined with sedation and analgesia in treating hypertensive intracerebral hemorrhage broken into ventricles.

Methods

Retrospective analysis of 169 patients diagnosed as hypertensive intracerebral hemorrhage into the ventricles of the brain, assigned to Monitoring and treatment group (n=57), treatment group (n=69) and control group (n=43) according to clinical practice. All patients was performed the external brain drainage, while the monitoring and treatment group were monitored by dynamic intracerebral intracranial pressure monitoring with sedative and analgesia. And the treatment group was treated with sedative and analgesia. Nerve function defect degree, GCS score, GOS score, time of NICU hospitalization and etc. were compared in each group after 6 months of follow-up.

Results

Neurological deficit score, GCS score, GOS score, NICU hospitalization time, and treatment group were significantly better than that of the treatment group and the control group (P<0.05), and the amount of mannitol and the rate of impaired renal function and electrolyte disorders were reduced significantly (P<0.05).

Conclusion

Intracranial pressure monitoring, can accurately understand the changes of intracranial pressure in patients with hypertensive intracerebral hemorrhage broken into ventricles, avoiding overuse of dehydrating agent and improving the prognosis. While that combined sedation and analgesia treatment has more significant effect, which is suitable for clinical application.

表1 3组患者一般资料比较
表2 3组患者神经功能缺损评分对比(±s,分)
表3 3组患者总体预后对比(±s
表4 3组患者甘露醇使用量及不良反应对比
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