摘要
目的:探究颅内压监测仪监测指导调整甘露醇剂量对重型颅脑损伤术后患者心肺功能的影响。方法:采用随机数字表法将鹰潭市人民医院2020年4月—2023年4月收治的140例重型颅脑损伤患者分为研究组(n=70)及对照组(n=70)。对照组术后采用腰穿结合CT复查结果调整甘露醇使用剂量,研究组则采用颅内压监测仪调整甘露醇使用量。对比两组心肺功能[全心射血分数(GEF)、全身血管阻力指数(SVRI)、胸腔内血容量指数(ITBVI)、肺血管通透性指数(PVPI)、血管外肺水指数(EVLWI)]、脱水效果、甘露醇使用情况、并发症发生情况。结果:相比于对照组,研究组治疗后GEF、SVRI、ITBVI、PVPI均较高,差异均有统计学意义(P<0.05);两组治疗后EVLWI对比,差异无统计学意义(P>0.05)。相比于对照组,研究组治疗后颅内压及脑水肿体积均较小,差异均有统计学意义(P<0.05)。相比于对照组,研究组甘露醇使用时间较短,使用剂量较少,差异均有统计学意义(P<0.05)。相比于对照组,研究组电解质紊乱、肺水肿、恶心呕吐发生率均较低,差异均有统计学意义(P<0.05);两组惊厥、低钠血症发生率对比,差异均无统计学意义(P>0.05)。结论:重型颅脑损伤患者术后采用颅内压检测仪监测指导能够更加准确地调整甘露醇使用剂量,在确保脱水效果的同时对患者的心肺功能影响较小,且安全可靠。
Objective:To explore the effect of intracranial pressure monitor monitoring guided adjustment of Mannitol dosage on cardiopulmonary function of patients after severe traumatic brain injury surgery.Method:A total of 140 patients with severe craniocerebral injury admitted to Yingtan City People's Hospital from April 2020 to April 2023 were divided into study group(n=70)and control group(n=70)by random number table method.The control group adjusted the dose of Mannitol by lumbar puncture combined with CT reexamination results,and the study group adjusted the dose of Mannitol by intracranial pressure monitor.The cardiopulmonary function[global ejection fraction(GEF),systemic vascular resistance index(SVRI),intrathoracic blood volume index(ITBVI),pulmonary vascular permeability index(PVPI),extravascular lung water index(EVLWI)],dehydration effect,Mannitol use and complications were compared between the two groups.Result:Compared with the control group,GEF,SVRI,ITBVI and PVPI in the study group were higher after treatment,the differences were statistically significant(P<0.05).There was no significant difference in EVLWI between the two groups after treatment(P>0.05).Compared with the control group,intracranial pressure and cerebral edema volume in the study group after treatment were smaller,the differences were statistically significant(P<0.05).Compared with the control group,the duration of Mannitol in the study group was shorter and the dosage was less,the differences were statistically significant(P<0.05).Compared with the control group,the incidence of electrolyte disturbance,pulmonary edema,nausea and vomiting in the study group were lower,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of convulsion and hyponatremia between two groups(P>0.05).Conclusion:Monitoring and guidance by intracranial pressure monitor for patients after severe traumatic brain injury surger can more accurately adjust the dose of mannitol,which has less influence on the cardiopu
作者
夏克江
吴小琴
童威
XIA Kejiang;WU Xiaoqin;TONG Wei(Department of Neurosurgery,Yingtan City People's Hospital,Yingtan 335000,China;不详)
出处
《中国医学创新》
CAS
2024年第17期153-157,共5页
Medical Innovation of China
关键词
重型颅脑损伤
颅内压监测仪
甘露醇
心肺功能
并发症
Severe traumatic brain injury
Intracranial pressure detector
Mannitol
Cardiopulmonary function
Complications
