持续颅内压监测在小脑出血手术中的应用

目的探讨持续颅内压监测在小脑出血手术中的临床意义。方法回顾性分析16例小脑出血手术患者的临床资料,均采用脑室内颅内压监测,根据ICP值调节脱水剂的用量。结果全组死亡5例,其中3例为有严重合并症的老年患者,1例为脑干功能衰竭,1例为再出血,家属放弃治疗。颅内压监测5~14d,平均7.8d,无探头植入引起的颅内大出血,2例发生颅内感染,对症治疗后好转。经过3个月~1年的随访,平均8个月,根据GOS评分:良好7例,中残3例,重残1例。结论小脑出血患者手术后应用持续颅内压监测,可指导降颅压药物的实施,能及早、安全拔除脑室引流,对减少颅内感染的发生有着积极的临床意义,操作简单,值得推广。

Application on sustained intracranial pressure monitoring on cerebellar hemorrhage

Objective To explore the clinical importance of sustained intracranial pressure （ICP） monitoring on eerebellar hemorrhage. Methods The clinical data of 16 patients with with cerebellar hemorrhage who underwent ICP monitoring were analyzed retrospectively. Dosage of dehydrater were adjusted by intraeranial pressure value. Results Of 16 patients,5 died, 3 were senile patient with severe complication, 1 with brainstem function failure, 1 with rehemorrhage who give up treatmeat. ICP monitoring underwent 5-14 days, averaged 7.8 days. There were on severe hemorrhage originated transducer embedding, there were 2 cases with intracranial infection who improved by treatment. The follow-up from 3 months to 2 years, averaged 8 months showed 7 patients had good recovery, 3 with moderate disability, 1 with severe disability according to Glasgow Outcome Score （GOS）. Conclusions We can guided our measure of administrating ICP, promptly removed ventrieular drainage and decreased intracranial infection by ICP monitoring on patients with cerebellar hemorrhage. The method were simple and deserved generalization.