持续颅内压监测在自发性脑出血破入脑室治疗中的作用

目的 探讨持续颅内压监护在自发性脑出血破入脑室治疗中的临床价值.方法 将60例自发性脑出血破入脑室患者根据随机数字表法分为两组,各30例.治疗组行侧脑室穿刺引流,并持续性对其颅内压监护;对照组患者单纯行侧脑室穿刺引流,对其临床资料进行回顾性分析.结果 治疗1周后,治疗组评价GCS评分（10.2±1.8）分,对照组GCS评分（8.4±2.7）分,两组比较差异具有统计学意义（t=3.038,P〈0.05）.治疗组GCS评分3～5分,6～8分患者比例均显著低于对照组,9～12分患者比例高于对照组,差异均有统计学意义（χ^2=4.04、4.81、10.80,均P〈0.05）.随访6个月,治疗组病死率为3.3%,重度残疾率为6.7%,再出血率为10.0%,均显著低于对照组,其预后良好率为80.0%,显著高于对照组,差异均具有统计学意义（χ^2=4.04、21.60、4.32、4.81,均P〈0.05）.结论 在自发性脑出血破入脑室治疗中实施颅内压监测,可以指导临床诊疗,对提高患者生存率,改善患者的预后均有重要临床价值.

Effect of continuous intracranial pressure monitoring in spontaneous intracerebral hemorrhage broken into ventricles

Objective To investigate the effect of continuous intracranial pressure monitoring in spontaneous intracerebral hemorrhage broken into ventricles. Methods According to the digital table,60 patients with spontaneous intracerebral hemorrhage broken into ventricles were divided into two groups, 30 cases in each group. The treatment group underwent ventricle puncture and drainage, and received continously intracranial pressure monitoring, and the control group underwent simple ventricle puncture and drainage. The chnical data were retrospectively analyzed. Results One week after treatment, the GCS score of the treatment group was （ 10.2 ± 1.8） points, which was significantly higher than （ 8.4 ± 2.7 ） points of the control group （ t = 3. 038, P 〈 0. 05 ）. In the treatment group, the propor- tions of GCS score 3 -5,6 -8 points were significantly lower than those of the control group, the proportion of GCS score 9 - 12 points was significantly higher than the control group, the differences were statistically significant （ X^2 = 4.04,4.81,10.80, all P 〈 0.05 ）. Follow-up for 6 months, the mortality rate of the treatment group was 3.3%, severe disability rate was 6.7% ,rebleeding rate was 10.0% ,which were significantly lower than those of the control group, the prognosis good rate was 80.0% ,which was significantly higher than that of the control group,the differences were statistically significant（X^2 =4.04,21.60,4.32,4.81 ,all P 〈0.05）. Conclusion In the treatment of spontaneous intracerebral hemorrhage broken into ventricles ,intracranial pressure monitoring implementation can guide clinical diagnosis and treatment, and improve the survival and prognosis of patients,it has important clinical value.