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目的利用闪光视觉诱发电位监测颅内高压患者颅压水平,研究降颅压效果与甘露醇用量以及其他影响因素的关系。方法选择60例颅内高压患者,应用NIP-200型无创颅内压监测仪监测患者每日颅压,计算最高颅压与最低颅压间的差值(降颅压效果),采用多元逐步回归方法分析降颅压效果与性别,年龄,最高颅压时的心率、血压以及降至最低颅压时甘露醇总用量的关系。结果60例患者最低颅压平均值为(213·4±66·8)mmH2O(83·5~364·5mmH2O),患者的颅压水平从入院至最低值时甘露醇总用量的平均值为(1870·8±861·9)ml(375~4000ml)。降颅压效果与最高颅压时的血压(舒张压和收缩压)和心率无相关性(P>0·05),与性别、年龄显著相关(P<0·05),与甘露醇用量显著相关(P<0·01)。结论甘露醇有明显的降颅压作用,但是用到一定的剂量后,便不再有降颅压作用。女性患者比男性患者降颅压的效果好。患者年龄越小,降颅压效果越好。
Objective To monitor the intracranial pressure in patients with intracranial hypertension by flash visual evoked potentials and to study the relationship between the effects of intracranial pressure reduction and the amount of mannitol and other influencing factors. Methods Sixty patients with intracranial hypertension were enrolled in this study. The daily intracranial pressure was monitored by NIP-200 noninvasive intracranial pressure monitor. The difference between the highest intracranial pressure and the lowest intracranial pressure (intracranial pressure lowering effect) was calculated. Multivariate stepwise regression Methods The relationship between the effect of reducing intracranial pressure and the gender, age, heart rate at the time of the highest intracranial pressure, blood pressure, and the total amount of mannitol reduced to the lowest intracranial pressure were analyzed. Results The mean minimum ICV of 60 patients was (213.4 ± 66.8) mmH2O (83.5 ~ 364.5 mmH2O). The average value of intracranial pressure from the admission to the lowest value was ( 1870 · 8 ± 861 · 9) ml (375 ~ 4000ml). There was no significant correlation between decreasing intracranial pressure and blood pressure (diastolic pressure and systolic pressure) and heart rate at the peak intracranial pressure (P> 0.05), and significant correlation with gender and age (P <0.05) Related (P <0.01). Conclusion Mannitol significantly reduced intracranial pressure, but with a certain dose, there will no longer reduce intracranial pressure. Female patients than male patients reduce the effect of intracranial pressure. The smaller the patient’s age, the better the effect of reducing intracranial pressure.