颅内压监测联合后颅窝减压术在小脑大面积梗死的应用研究(1)
摘要：目的 探讨持续颅内压监测联合后颅窝减压术在小脑大面积梗死中的临床疗效。方法 本科室2016年1月～2017年6月收治的小脑大面积梗死患者共45例，随机分为观察组和对照组，观察组给予颅内压监测联合后颅窝减压术治疗，对照组单纯给予后颅窝减压术治疗，观察两组患者术后恢复情况。结果 出院后经过随访3个月、6个月时日常生活活动(ADL)评分，观察组为(66.5±29.9)分，对照组为(42.1±26.8)分，两组比较差异具有统计学意义(P<0.05)，死亡率的差异两组比较无统计学意义(P>0.05)。结论 小脑大面积梗死患者手术中及手术后持续性监测颅内压，能指导药物治疗以及早期、安全拔除脑室引流，进而减少颅内感染的发生。
关键词：颅内压监测；后颅窝减压术；小脑大面积梗死
中图分类号：R651.1+1 文献标识码：A 文章编号：1006-1959(2017)21-0033-03
Application of Intracranial Pressure Monitoring Combined with Posterior Cranial Fossa Decompression in Large Cerebellar Infarction
, http://www.100md.com
HUANG Qian-liang，LI Wei，HUANG Wei-long
(Department of Neurosurgery，Ganzhou People's Hospital，Ganzhou 341000，Jiangxi，China)
Abstract：Objective To investigate the clinical effect of continuous intracranial pressure monitoring combined with posterior fossa decompression in large area cerebellar infarction.Methods In January 2016～June 2017 from the cerebellum large area of infarction patients with a total of 45 cases were randomly divided into observation group and control group，the observation group was given intracranial pressure monitoring combined with posterior fossa decompression treatment，the control group was treated with posterior fossa decompression treatment and recovery were observed in two groups.Results After a follow-up of 3 months，6 months of activities of daily living(ADL)score，the observation group was(66.5±29.9)points，the control group (42.1±26.8)points，with significant differences between the two groups(P<0.05)，the difference in mortality between the two groups had no statistical significance(P>0.05).Conclusion Continuous monitoring of intracranial pressure during operation and after operation can guide the drug treatment and early and safe removal of ventricular drainage，thus reducing the incidence of intracranial infection.
, 百拇医药
Key words：Intracranial pressure monitoring；Posterior fossa decompression；Cerebellar large area infarction
急性缺血性脑血管疾病是一种常见的、致残率和死亡率较高的神经科疾病。其中大面积小脑梗死是神经外科的重症疾病，发病突然，死亡率高，大部分患者术后往往肢体残疾，严重影响患者生活质量，治疗效果不理想[1]。有报道表明，小脑梗死的死亡率占全部脑梗死的15%，为临床的危重病症[2]。本课题组收治2016年1月～2017年6月来我院诊治的45例小脑大面积梗死患者，随机分为观察组和对照组，现将治疗结果报道如下。
1资料与方法
1.1一般资料
收集本科室2016年1月～2017年6月收治的45例确诊小脑大面积梗死患者，男31例，女14例，年龄52～75岁，平均年龄(58.5±3.1)岁。45例患者均有不同程度高血压病史，合并冠心病史8例、糖尿病史6例。临床表现：活动中发病共32例，静态情况下发病13例，均急性起病。头颅CT检查显示：一侧半球梗死28例，双侧半球梗死15例，一侧半球+蚓部梗死2例。昏迷程度分级：轻度昏迷16例，中度昏迷19例，重度昏迷10例。术前GCS评分5～13分，平均GCS評分(7.3±1.2)分。将患者随机分为观察组和对照组，观察组23例，对照组22例。已排除无手术适应征及治疗前死亡病例。两组患者在年龄、性别及合并症等方面无差异(P>0.05)。, http://www.100md.com(黄乾亮 李卫 黄伟龙)
关键词：颅内压监测；后颅窝减压术；小脑大面积梗死
中图分类号：R651.1+1 文献标识码：A 文章编号：1006-1959(2017)21-0033-03
Application of Intracranial Pressure Monitoring Combined with Posterior Cranial Fossa Decompression in Large Cerebellar Infarction
, http://www.100md.com
HUANG Qian-liang，LI Wei，HUANG Wei-long
(Department of Neurosurgery，Ganzhou People's Hospital，Ganzhou 341000，Jiangxi，China)
Abstract：Objective To investigate the clinical effect of continuous intracranial pressure monitoring combined with posterior fossa decompression in large area cerebellar infarction.Methods In January 2016～June 2017 from the cerebellum large area of infarction patients with a total of 45 cases were randomly divided into observation group and control group，the observation group was given intracranial pressure monitoring combined with posterior fossa decompression treatment，the control group was treated with posterior fossa decompression treatment and recovery were observed in two groups.Results After a follow-up of 3 months，6 months of activities of daily living(ADL)score，the observation group was(66.5±29.9)points，the control group (42.1±26.8)points，with significant differences between the two groups(P<0.05)，the difference in mortality between the two groups had no statistical significance(P>0.05).Conclusion Continuous monitoring of intracranial pressure during operation and after operation can guide the drug treatment and early and safe removal of ventricular drainage，thus reducing the incidence of intracranial infection.
, 百拇医药
Key words：Intracranial pressure monitoring；Posterior fossa decompression；Cerebellar large area infarction
急性缺血性脑血管疾病是一种常见的、致残率和死亡率较高的神经科疾病。其中大面积小脑梗死是神经外科的重症疾病，发病突然，死亡率高，大部分患者术后往往肢体残疾，严重影响患者生活质量，治疗效果不理想[1]。有报道表明，小脑梗死的死亡率占全部脑梗死的15%，为临床的危重病症[2]。本课题组收治2016年1月～2017年6月来我院诊治的45例小脑大面积梗死患者，随机分为观察组和对照组，现将治疗结果报道如下。
1资料与方法
1.1一般资料
收集本科室2016年1月～2017年6月收治的45例确诊小脑大面积梗死患者，男31例，女14例，年龄52～75岁，平均年龄(58.5±3.1)岁。45例患者均有不同程度高血压病史，合并冠心病史8例、糖尿病史6例。临床表现：活动中发病共32例，静态情况下发病13例，均急性起病。头颅CT检查显示：一侧半球梗死28例，双侧半球梗死15例，一侧半球+蚓部梗死2例。昏迷程度分级：轻度昏迷16例，中度昏迷19例，重度昏迷10例。术前GCS评分5～13分，平均GCS評分(7.3±1.2)分。将患者随机分为观察组和对照组，观察组23例，对照组22例。已排除无手术适应征及治疗前死亡病例。两组患者在年龄、性别及合并症等方面无差异(P>0.05)。, http://www.100md.com(黄乾亮 李卫 黄伟龙)