摘要
目的 探究颅内压(ICP)监测用于高血压脑出血(HICH)患者的预后改善及神经保护作用。方法 选取2019年1月~2021年12月南京医科大学第一附属医院(江苏省人民医院)收治的128例HICH患者,按术后是否监测ICP,将患者分为对照组和研究组。对照组患者手术后接受常规的血压检测,研究组患者在手术后接受ICP监测。比较两组患者的一般资料、预后情况、血清学指标、国立卫生研究院卒中量表(NIHSS)评分、围术期各项指标及并发症发生情况。结果 研究组60例,对照组68例。两组患者的年龄、性别及出血部位等一般资料差异无统计学意义(P> 0.05);研究组患者的预后良好率96.66%显著高于对照组79.41%,差异有统计学意义(P <0.05);术后1、7和14 d研究组的血清超敏C反应蛋白(hs-CRP)及白细胞介素6(IL-6)水平较对照组显著降低,差异有统计学意义(P <0.05);研究组NIHSS评分(8.71±2.57)分较对照组显著降低,差异有统计学意义(P <0.05);研究组患者的甘露醇使用天数(4.28±0.71) d、甘露醇使用剂量(2527.31±289.67)ml及ICU住院天数(4.11±0.91) d较对照组显著降低,差异有统计学意义(P <0.05);研究组患者的并发症总发生率10.00%显著低于对照组23.53%,差异有统计学意义(P <0.05)。结论 HICH患者术后接受ICP监测,能指导甘露醇的合理使用,减少ICU住院天数,改善患者的预后情况,促进神经功能恢复,降低并发症的发生率,具有广泛的临床应用价值。
Objective To investigate the prognostic improvement and neuroprotective effect of intracranial pressure(ICP)monitoring in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 128 patients with HICH admitted to our hospital fromJanuary 2019 to December 2021 were selected as the research objects.According to the different postoperative treatment methods,the patients were divided into the control group and the study group.Patients in the control group received routine blood pressure detection after surgery,while patients in the study group received ICP monitoring after surgery.The general data,prognosis,serological indicators,National Institutes of Health Stroke Scale(NIHSS)score,perioperative indicators and complications were compared between the two groups.Results There were 60 cases in study group and 68 cases in control group.There was no significant difference in age,gender and bleeding site between the two groups(P>0.05).The good prognosis rate of the study group(96.66%)was significantly higher than that of the control group(79.41%)(P<0.05);The serum hs-CRP and IL-6 levels in the study group were significantly lower than those in the control group at 1,7 and 14 days after operation(P<0.05).The NIHSS score of the study group(8.71±2.57)was significantly lower than that of the control group(P<0.05);The days of mannitol use(4.28±0.71)days,the dose of mannitol use(2527.31±289.67)mL and the days of ICU stay(4.11±0.91)days in the study group were significantly lower than those in the control group(P<0.05);The total complication rate of the study group(6.66%)was significantly lower than that of the control group(20.59%)(P<0.05).Conclusion ICP monitoring after HICH can guide the rational use of mannitol,reduce the length of ICU stay,improve the prognosis of patients,promote the recovery of neurological function,and reduce the incidence of complications,which has a wide range of clinical application value.
作者
李娜
赵麟
张程
陈锦园
童孜蓉
Li Na;Zhao Lin;Zhang Cheng(Neurosurgery ICU,The First Affiliated Hospital With Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210000,China)
出处
《中华保健医学杂志》
2023年第1期83-86,共4页
Chinese Journal of Health Care and Medicine
基金
江苏省科技项目(BK20210970)。
关键词
颅内压监测
高血压脑出血
神经功能
格拉斯哥预后评分
预后改善
Intracranial pressure monitoring
Hypertensive cerebral hemorrhage
Neurological function
GOS score
To improve the prognosis
