谭泽梁;杨志勇;蔡成柱;陈越;何芷怡;

• 1:茂名市人民医院神经重症医学科

摘要(Abstract)：

目的由于脑出血患者较缺乏颅内压(ICP)系统的研究,目前推荐的脑出血ICP管理主要来自于TBI治疗的经验,尚缺乏直接证据。本研究旨在探讨ICP与脑出血结果的相关性,并分析临界值ICP>20mmHg(依据TBI资料)是否适用于脑出血。方法前瞻性持续纳入在2010-01-01-2015-06-31入住神经科的昏迷脑出血且均进行了ICP监控的患者。发病3个月转归采用mRS评分。多变量逻辑回归分析探讨ICP与预后相关的危险因素。结果最后纳入98例患者分析。ICP均值(OR1.2,CI 1.08¹.45,P=0.003),ICP最大值(OR1.06,1.011.45,P=0.003),ICP最大值(OR1.06,1.01¹.1,P=0.015),ICP方差(OR 1.3,1.031.1,P=0.015),ICP方差(OR 1.3,1.03¹.73,P=0.03),以及ICP值>20mmHg的相对频率(OR1.1,1.021.73,P=0.03),以及ICP值>20mmHg的相对频率(OR1.1,1.02¹.15,P=0.008)都与随访3个月时病死率显著相关。ICP值>20mmHg的相对频率(OR1.1,1.021.15,P=0.008)都与随访3个月时病死率显著相关。ICP值>20mmHg的相对频率(OR1.1,1.02¹.15,P=0.008)也与随访3个月时病死率显著相关。结论 ICP可变性及ICP值>20 mmHg的频率与脑出血后病死率和不良结局呈独立相关。将来应开展前瞻性研究进一步确定我们的结论,同时验证ICP的参考阈值。

关键词(KeyWords)： 颅内出血;结局;颅内压;脑灌注压

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 谭泽梁;杨志勇;蔡成柱;陈越;何芷怡;

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