| 方有利,刘万荣,王辉,等.小骨窗开颅血肿清除术联合有创颅内压监测治疗高血压脑出血34例分析[J].安徽医药,2019,23(6):1119-1120. |
| 小骨窗开颅血肿清除术联合有创颅内压监测治疗高血压脑出血34例分析 |
| Analysis of 34 cases of hypertensive intracerebral hemorrhage treated by small bone window craniotomy combined with invasive intracranial pressure monitoring |
| 投稿时间：2017-08-08 |
| DOI： |
| 中文关键词: 高血压脑出血 有创颅内压监测 小骨窗 |
| 英文关键词: Hypertensive cerebral hemorrhage Invasive intracranial pressure monitoring Small bone window |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨小骨窗开颅血肿清除术联合有创颅内压监测技术指导高血压脑出血治疗的临床疗效。方法 回顾性分析2016年1月至2017年1月间霍邱县第一人民医院神经外科收治的高血压脑出血病例34例。所有病例均通过小骨窗开颅血肿清除联合有创颅内压监测进行治疗。观察颅内压值,术后再出血、梗死发生率,药物干涉调控颅内压使用率,有创颅内压并发症发生率以及病人重症监护时间及预后。结果 术后颅内压<20 mmHg者 25例,≥20 mmHg者 9例；术后再出血5例；甘露醇使用20例；发生颅内感染1例；神经外科重症监护平均时间4.5 d,术后持续随访6个月,存活32例[日常生活活动(activity of daily living,ADL)评分:Ⅰ级5例,Ⅱ级20例,Ⅲ级4例,Ⅳ级2例,Ⅴ级1例],死亡2例。结论 术后有创颅内压监测对指导术后药物应用,避免颅内压波动和降低再出血风险,改善预后有一定程度的指导意义。 |
| 英文摘要: |
| Objective To investigate the effect of small bone window craniotomy combined with invasive intracranial pressure monitoring technology on the treatment of hypertensive cerebral hemorrhage.Methods Thirty-four cases of hypertensive cerebral hemorrhage treated in Department of Neurosurgery,The First People's Hospital of Huoqiu from January 2016 to January 2017 were retrospectively analyzed.All the cases were treated using small bone window craniotomy for hematoma removal combined with invasive intracranial pressure monitoring.The intracranial pressure,incidences of postoperative hemorrhage and infarction,drug use rate of intracranial pressure monitoring,incidence of complications of invasive intracranial pressure,length of time in ICU and prognosis were observed.ResultsIn 25 cases the postoperative intracranial pressure was below 20 mmHg,while in the other 9 cases the postoperative intracranial pressure was equal to or higher than 20 mmHg.Postoperative bleeding occurred in 5 cases,and intracranial infection occurred in 1 case.Mannitol was used in 20 cases.The average time for intensive care monitoring in the Department of Neurosurgery was 4.5 day and the follow-up lasted for 6 months.Thirty-two cases survived [activity of daily living (ADL) scale:gradeⅠin 5 cases,gradeⅡ in 20 cases,grade Ⅲ in 4 cases,grade Ⅳ in 2 cases,and grade Ⅴ in 1 case],and 2 cases died.Conclusion Invasive intracranial pressure monitoring is helpful to guide the application of postoperative drugs,avoid intracranial pressure fluctuation,reduce the risk of rebleeding and improve prognosis. |
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