持续性颅内压监护对高血压脑出血治疗手术时机及甘露醇用量调控的指导价值研究(1)
【摘要】 目的：探討持续性颅内压监护对高血压脑出血患者手术时机选择及甘露醇用量调控的指导价值。方法：选取2015年8月-2017年10月本院收治的高血压脑出血患者54例。按照随机分配原则将其分为监护组(n=27)和对照组(n=27)。两组均给予常规治疗及行小骨窗开颅脑内血肿清除术，监护组在颅内压数值指导下调控甘露醇用量，对照组则依据患者意识情况、影像资料等调整甘露醇使用频次。比较两组手术时机、甘露醇减量时间、治疗前后的格拉斯哥预后量表(GOS)评分及并发症情况。结果：监护组手术介入时机明显早于对照组(P<0.05)；监护组甘露醇减量时间明显短于对照组(P<0.05)；治疗后，两组GOS评分均高于治疗前，且监护组明显高于对照组，比较差异均有统计学意义(P<0.05)；监护组并发症发生率为7.41%，明显低于对照组的44.44%，比较差异有统计学意义(P<0.05)。结论：持续颅内压监护可以有效调控甘露醇用量，指导手术时机，减少并发症，促进预后恢复，在个体化治疗中具有较高价值。
【关键词】 高血压脑出血； 颅内压监护； 手术时机； 甘露醇； 并发症
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【Abstract】 Objective：To explore the guiding value of continuous intracranial pressure monitoring on the timing of operation and mannitol dosage in patients with hypertensive intracerebral hemorrhage.Method：A total of 54 patients with hypertensive intracerebral hemorrhage in our hospital from August 2015 to October 2017 were selected.According to the principle of random distribution，they were divided into guardianship group(n=27) and control group(n=27).They were given conventional treatment and small bone window craniotomy for intracerebral hematoma removal.The monitoring group regulates Mannitol dosage under the guidance of intracranial pressure，and control group adjusts the frequency of mannitol use according to the patients' consciousness and image data.The timing of operation，mannitol reduction time and the complications between two groups were compared，the Glasgow prognosis scale(GOS) before and after treatment were compared.Result：The timing of operation intervention in monitoring group was earlier than that of control group(P<0.05).The mannitol reduction time of monitoring group was significantly shorter than that of control group(P<0.05).After treatment，the GOS scores in two groups were higher than those of before treatment，and monitoring group was significantly higher than that of control group，the differences were statistically significant(P<0.05).The incidence of complications in monitoring group was 7.41%，which was significantly lower than 44.44% of control group，the difference was statistically significant(P<0.05).Conclusion：Continuous intracranial pressure monitoring can effectively control Mannitol dosage，guide the timing of operation，reduce complications and promote prognosis，which is a high value in individualized treatment.
【Key words】 Hypertensive intracerebral hemorrhage； Intracranial pressure monitoring； Timing of operation； Mannitol； Complications
First-author’s address：Dongguan Tung Wah Hospital，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2018.05.030, 百拇医药(周丹 刘茹 刘俊)
【关键词】 高血压脑出血； 颅内压监护； 手术时机； 甘露醇； 并发症
, http://www.100md.com
【Abstract】 Objective：To explore the guiding value of continuous intracranial pressure monitoring on the timing of operation and mannitol dosage in patients with hypertensive intracerebral hemorrhage.Method：A total of 54 patients with hypertensive intracerebral hemorrhage in our hospital from August 2015 to October 2017 were selected.According to the principle of random distribution，they were divided into guardianship group(n=27) and control group(n=27).They were given conventional treatment and small bone window craniotomy for intracerebral hematoma removal.The monitoring group regulates Mannitol dosage under the guidance of intracranial pressure，and control group adjusts the frequency of mannitol use according to the patients' consciousness and image data.The timing of operation，mannitol reduction time and the complications between two groups were compared，the Glasgow prognosis scale(GOS) before and after treatment were compared.Result：The timing of operation intervention in monitoring group was earlier than that of control group(P<0.05).The mannitol reduction time of monitoring group was significantly shorter than that of control group(P<0.05).After treatment，the GOS scores in two groups were higher than those of before treatment，and monitoring group was significantly higher than that of control group，the differences were statistically significant(P<0.05).The incidence of complications in monitoring group was 7.41%，which was significantly lower than 44.44% of control group，the difference was statistically significant(P<0.05).Conclusion：Continuous intracranial pressure monitoring can effectively control Mannitol dosage，guide the timing of operation，reduce complications and promote prognosis，which is a high value in individualized treatment.
【Key words】 Hypertensive intracerebral hemorrhage； Intracranial pressure monitoring； Timing of operation； Mannitol； Complications
First-author’s address：Dongguan Tung Wah Hospital，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2018.05.030, 百拇医药(周丹 刘茹 刘俊)
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