持续颅内压监测在小脑出血手术中的应用.pdfVIP

72 J Clin Neurosl吨，February 20l4 ,Vol. ll ,No.l doi: 10. 3969/j. issn. 1672-7770.2014.01.023 ·临床研究· 持续颅内压监测在小脑出血手术中的应用 王志明，殷尚炯，王阳春，刘福增，孟文博 {摘要} 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 倒小脑出血手术 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 ωs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。 [关键词] 小脑出血;手术;颅内压监测 [中图分类号1 R65 1. 1 [文献标识码1 D [文章编号1 1672-7770(2014)01 咽72-02 Application on sustained intracranial pres啤ure monitoring on cerebellar hemorrhage WANG Zhi-ming , YIN Shang-jiong , WANG Yang-chun ,et al. Department 0/ Neurosurgery ,the 251st Hospital 0/ PLA ,Zhangjiakou fJ75000 ,China Abstract:Objective To explore the clinical importance of sustained intracranial pressure( ICP) monitoring on cerebellar 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 intracranial 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 recove巧， 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 ventricular drainage and decreased intracranial in