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目的探讨丘脑出血破入脑室、颅内压监测、脑灌注压在丘脑综合治疗中的应用价值。方法对161例丘脑出血破入脑室(监测组)在保证脑灌注压(CPP)9.23~12KPA条件下持续颅内(ICP)及平均动脉压(MAP)监测,并在保持ICP0.8~2KPA情况下,丘脑出血脑室铸型出血行双侧脑室置管外引流并腰穿脑脊液置换术。对98例高血压脑室铸型出血患者(对照组),持续血压监测,控制血压于发病前水平或低于入院水平20%,对比两组治疗效果,同时评价在保证脑灌注压条件下颅内压监测在丘脑出血救治中应用价值。结果监测组死亡率5.6%(9/161)低于对照组死亡率18.3%(18/98)两组比较差异有统计学意义(P<0.050)。结论保证脑灌注压、颅内压监测下血压控制可改善丘脑出血患者预后。
Objective To investigate the clinical value of thalamic hemorrhage penetrating the ventricles, monitoring of intracranial pressure and cerebral perfusion pressure in the treatment of thalamic complex. Methods 161 cases of thalamic hemorrhage broken into the ventricle (monitoring group) under continuous cerebral perfusion pressure (CPP) 9.23 ~ 12KPA continuous intracranial (ICP) and mean arterial pressure (MAP) monitoring, and maintain ICP0.8 ~ 2KPA Under the thalamic hemorrhage intraventricular cast hemorrhage line bilateral ventricle catheter drainage and lumbar puncture cerebrospinal fluid replacement surgery. 98 patients with hypertensive intracerebral hemorrhage (control group), continuous blood pressure monitoring, control of blood pressure before onset or less than 20% of hospital admission, compared the two groups were treated with the same time, to assess the conditions of cerebral perfusion pressure in the intracranial Application of pressure monitoring in treatment of thalamic hemorrhage. Results The mortality rate in the monitoring group was 5.6% (9/161), which was lower than that in the control group (18.3%, 18/98). There was significant difference between the two groups (P <0.050). CONCLUSIONS: To ensure cerebral perfusion pressure and blood pressure control under intracranial pressure monitoring can improve the prognosis of patients with thalamic hemorrhage.