动态颅压监测对重度高血压脑出血患者去骨瓣减压术后治疗及预后的影响

去骨瓣减压手术是治疗高血压脑出血的重要治疗手段,能够能有效降低患者颅内压,促进损伤神经修复。颅内压升高是导致高血压脑出血患者病情急剧恶化的直接原因,通过动态监测脑出血患者颅内压对评估疗效及预后有重要意义。结果发现,去骨瓣减压手术后实施动态颅内压监测,甘露醇使用总剂量显著减少,住院时间显著缩短,术后并发症发生率及术后10天白血病介素(IL)-6、超敏C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)等水平显著较低,术后半年ADL等级明显提高。这表明重度高血压脑出血患者去骨瓣减压术后实施动态颅内压监测,能及时发现患者病情变化,有效应用药物降压,降低患者术后并发症发生率,改善远期预后,值得临床借鉴。

Effect of dynamic intracranial pressure monitoring on the treatment and prognosis of patients with severe hypertensive cerebral hemorrhage after decompressive craniectomy

Decompressive craniectomy is an important treatment for hypertensive cerebral hemorrhage. It can effectively reduce the intracranial pressure of patients and promote the repair of injured nerves. Increased intracranial pressure is a direct cause of rapid deterioration of hypertensive cerebral hemorrhage. Dynamic monitoring of intracranial pressure in patients with cerebral hemorrhage is of great importance for evaluating the curative effect and the prognosis. In this study, the application of dynamic monitoring of intracranial pressure after decompressive craniectomy, the total dosage of mannitol after operation was significantly less, length of hospital stay was significantly shorter, the incidence of postoperative complications and levels of IL-6, hs-CRP and NSE were significantly lower, and the grade of ADL was significantly higher in the observation group. Therefore, the application of dynamic monitoring of intracranial pressure in patients with severe hypertensive cerebral hemorrhage after decompressive craniectomy can timely find changes of patient''s condition. The effective use of antihypertensive drugs can reduce the incidence rate of postoperative complications, and improve the long-term prognosis of patients.