摘要
目的探讨无创脑水肿动态监护仪在出血性脑卒中患者中的应用价值。方法选取2021年5月~2022年2月于铜仁市人民医院神经外科治疗的60例出血性脑卒中患者,根据单双号将患者分为对照组和观察组,每组30例。对照组按照经验行常规治疗,观察组采用水肿动态监护仪对其进行监测,比较两组患者的平均每日使用甘露醇的剂量及天数、再出血情况、并发症及治疗有效率。结果观察组患者平均每日使用甘露醇的剂量及天数均少于对照组[(362.7±117.7)ml vs.(283.3±93.5)ml、(14.5±5.3)d vs.(11.6±4.6)d],差异有统计学意义(t=2.896、2.263,P<0.05)。观察组发生再出血患者1例(3.33%),较对照组患者10例(33.33%)显著降低,差异有统计学意义(χ^(2)=9.017,P<0.05)。观察组发生肾功能损害1例(3.33%)、电解质紊乱2例(6.67%)、其他并发症1例(3.33%),总发生率13.33%显著低于对照组50.00%,差异有统计学意义(χ^(2)=9.320,P<0.05)。出院3个月后依据格拉斯哥预后(GOS)评分细则对患者进行回访,经秩和检验结果显示,观察组的预后明显优于对照组,差异有统计学意义(Z=2.252,P<0.05)。结论无创脑水肿动态监护仪可灵敏的观察出血性脑卒中患者的病情变化,指导脱水药物的使用,动态调整治疗方案,减少并发症、提升疗效,可成为CT MRI等影像学检查的重要补充手段,在脑出血的辅助治疗过程中值得使用。
Objective To investigate the value of non-invasive cerebral edema dynamic monitor in patients with hemorrhagic stroke.Methods Based on the inclusion and exclusion criteria,60 patients with haemorrhagic stroke treated in Tongren People′s Hospital from May 2021 to February 2022 were selected as the study subjects,and the patients were divided into a control group and an observation group according to single and double numbers,with 30 cases in each group.The control group was treated conventionally according to experience,while the observation group was monitored using an oedema dynamic monitor.The average daily dose and number of days of mannitol,rebleeding,complications and treatment efficiency were compared between the two groups.Results The average daily doses and days of mannitol in the observation group were significantly less than those in the control group[(362.7±117.7)ml vs.(283.3±93.5)ml,(14.5±5.3)d vs.(11.6±4.6)d](t=2.896,2.263,P<0.05).In the observation group,1 case(3.33%)of rebleeding occurred,which was significantly lower than 10 cases(33.33%)in the control group(χ^(2)=9.017,P<0.05).1 case(3.33%)of renal impairment,2 cases(6.67%)of electrolyte disturbance and 1 case(3.33%)of other complications occurred in the observation group,with an overall incidence of 13.33%significantly lower than that of 50.00%in the control group(χ^(2)=9.320,P<0.05).3 months after discharge,the patients were returned to the hospital according to the GOS score rules,by rank sum test The result showed that the prognosis of the observation group was significantly better than that of the control group(Z=2.252,P<0.05).Conclusion The non-invasive cerebral oedema dynamic monitor can sensitively observe changes in the condition of patients with haemorrhagic stroke,guide the use of dehydrating drugs,dynamically adjust the treatment plan,reduce complications and improve the efficacy.
作者
胡晓
周杨
蔡力
刘坤明
李陈
Hu Xiao;Zhou Yang;Cai Li(Department of Neurosurgery,Tongren People′s Hospital,Tongren 554300,China)
出处
《中华保健医学杂志》
2023年第6期630-633,共4页
Chinese Journal of Health Care and Medicine
基金
铜仁市科技计划项目(铜市科研(2021)8-5号)。
关键词
水肿动态监护仪
出血性脑卒中
脑水肿
扰动系数
Oedema dynamic monitor
Haemorrhagic stroke
Cerebral oedema
Perturbation factor
