开颅血肿清除术联合有创颅内压监测对脑出血脑水肿期患者的应用价值分析OA
Analysis Value Application Value of Craniotomy Hematoma Removal Surgery Combined with Invasive Intracranial Pressure Monitoring in Patients with Cerebral Hemorrhage and Edema Stage
目的 分析脑出血行开颅血肿清除联合有创颅内压监测术后脑水肿期颅内压监测的应用价值.方法 选取2020 年 1 月至 2022 年 11 月新乡市第二人民医院脑出血患者 62 例,在区间随机法引导下均等划分组别,两组均接受开颅血肿清除术治疗,对照组、研究组各 31 例,对照组采取常规监护+治疗,根据尿、血常规等相关指标实时调整治疗方案;研究组采取在对照组基础上增加有创颅内压监测的方法进行治疗.比较两组术前、术后第三月神经缺损程度量表(NIHSS)评分、脑卒中评分(MRS)、格拉斯哥预后评分(GOS)、围术期甘露醇使用量及脑水肿其并发症发生情况.结果 手术前,两组NIHSS评分对比,差异无统计学意义(P＞0.05);术后第三月,两组NIHSS评分均有所下降,且研究组评分低于对照组,差异有统计学意义(P＜0.05).手术前,两组间MRS、GOS评分对比,差异无统计学意义(P＜0.05);术后第三月,两组MRS评分均有所下降,GOS评分均有所上升,研究组MRS评分低于对照组,研究组GOS评分高于对照组,差异有统计学意义(P＜0.05).研究组治疗第二日、第四日、第六日、第八日甘露醇使用量均低于对照组,差异有统计学意义(P＜0.05).研究组脑水肿期并发症发生率(6.45%)低于对照组(29.03%),差异有统计学意义(P＜0.05).结论 脑出血行开颅血肿清除联合有创颅内压监测能实现颅内压动态监测,在指导术后脑水肿期甘露醇的使用、降低并发症发生率、改善预后等方面均有一定积极意义,值得应用.
Objective To study the application value of craniotomy hematoma removal combined with invasive intracranial pressure monitoring in postoperative cerebral edema period.Methods A total of 62 patients with cerebral hemorrhage were selected from January 2020 to November 2022 at the Second People's Hospital of Xinxiang City.They were randomly divided into two groups under the guidance of interval random method.They were randomly divided into two groups under the guidance of interval randomization,with 31 patients in each group.Both groups received craniotomy hematoma removal treatment.The control group received routine monitoring and treatment,and the treatment plan was adjusted in real-time based on urinary and blood routine related indicators.The study group received additional invasive intracranial pressure monitoring treatment on the basis of the control group.The National Institutes of Health Stroke Scale(NIHSS)score,Modified Rankin Scal score(MRS),Glasgow Outcome Scale(GOS),perioperative use of mannitol and complications of cerebral edema were compared between the two groups.Results Before surgery,NIHSS scores between groups were not significantly different(P＞0.05);however,in the third month after surgery,NIHSS scores decreased in both groups,with the study group scoring lower than the control group,with a statistically significant difference(P＜0.05).Prior to surgery,there was no statistically significant difference in MRS and GOS scores between the two groups(P＜0.05);but in the third month after surgery,MRS scores decreased and GOS scores increased in both groups,with the research group having lower MRS scores and higher GOS scores compared to the control group,showing a statistically significant difference(P＜0.05).The amount of mannitol used in the research group on the second,fourth,sixth,and eighth days of treatment was lower than that in the control group,indicating a statistically significant difference(P＜0.05).The incidence of complications during the cerebral edema period in the research group(6.45%)was lower than that in the control group(29.03%),demonstrating a statistically significant difference(P＜0.05).Conclusion The craniotomy and invasive intracranial pressure monitoring can make the dynamic monitoring of intracranial pressure,reduce the mannitol use dosage and surgical complications,and improve the patient's clinical prognosis.
岳学智
新乡市第二人民医院 神经外科,河南 新乡 453000
临床医学
脑出血开颅血肿清除有创颅内压监测
cerebral hemorrhageremoval of craniotomy hematomainvasive intracranial pressure monitoring
《临床研究》 2024 (002)
23-26 / 4
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