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1、#328#解放军护理杂志2010年3月第27卷第3A期NursJChinPLA,March2010,Vol.27,No.3A重型颅脑损伤术后患者动态脑灌注压的监测及其意义曲虹,周丽娟,梁国标,李志清,高旭,王丹玲,赵丽萍=摘要>目的探讨重型颅脑损伤术后患者动态脑灌注压(cerebralperfusionpressure,CPP)的监测及其意义。方法选择伤后72h内首诊入院的重型颅脑损伤患者按入院先后随机分为非监护组和监护组各60例作为研究对象。非监护组采取常规治疗;监护组中伤后<24h内入院36例,伤后24~72h入院24例,进行持续CPP和同步生理监护,以
2、患者入院时的CPP值分为A组(CPP9.33kPa)和B组(CPP<9.33kPa),根据监测指标的变化(MABP、PaO2、体温、PaCO2等)给予早期临床干预。结果伤后24h内入院的监护组中,B组患者平均动脉压(MABP)为(8.33?1.08)kPa、血液PaO2为(7.88?2.78)kPa,明显低于A组的MABP(12.68?1.13)kPa和PaO2(12.22?2.33)kPa,经比较,差异有统计学意义(P<0.05);伤后24~72h入院的监护组中,B组颅内压(ICP)为(4.04?0.12)kPa,较A组(2.55?0.09)kPa明显增
3、高(P<0.05)。监护组与非监护组疗效经比较,差异有统计学意义(P<0.05)。结论重型颅脑损伤后的早期动态CPP监护有助于病情变化的正确判断,可为疾病的正确治疗、护理及其预后判断提供依据。=关键词>颅脑损伤;脑灌注压;监测;护理观察+=中图分类号>R651115;R1971323=文献标志码>A=文章编号>1008-9993(2010)3A-0328-03DynamicMonitoringandEffectsofCerebralPerfusionPressureinPatientswithSevereHeadInjuryQuHong,ZhouL-ijua
4、n,LiangGuo-biao,LiZh-iqing,GaoXu,WangDan-ling,ZhaoL-iping(DepartmentofNeurosurgery,GeneralHospitalShenyangMilitaryAreaCommand,Shenyang110016,China)=Abstract>ObjectiveToinvestigatethedynamicmonitoringofcerebralperfusionpressure(CPP)anditseffectsinpatientswithsevereheadinjury.Methods
5、Atotalof120patientswithsevereheadinjurywhowerehospitalizedwithin72haftertheinjurywererandomizedintomonitoringgroup(n=60)andnon-monitoringgroup(n=60)basedonadmissionsequence.Thepatientsinthemonitoringgroupwhowerehospitalizedwithin24h(n=36)or24-72h(n=24)afterinjurywerestudiedwithCPPa
6、ndphysiologicalmonitoringmethods,andweredividedintogroupA(CPP9.33kPa)andgroupB(CPP<9.33kPa)withearlyclinicalinterventionsaccordingtothemonitoringprotocols.ResultsForthemonitoringpatientshospitalizedwithin24h,thevalueofmeanarterialbloodpressure(MABP,8.33?1.08kPa)andarterialPaO2(7.8
7、8?2178kPa)ingroupBwerelowerthanthoseingroupA(MABP,12.68?1.13kPa;PaO2:12.22?2.33kPa).Forthemo-nitoringpatientshospitalizedin24-72h,theintracranialpressure(ICP,4.04?0.12kPa)wasincreasedsig-nificantlywhencomparedwiththatofgroupA(2.55?0.09kPa).Thereweresignificantdifferencesinthetherap
8、euticeffectsbetweenmonitor
