破裂脑动脉瘤不同时机夹闭术后的颅内压监测研究

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Abstract Objective To explore the characteristics of intracranial pressure (ICP) in patients after ruptured cerebral aneurysms clipped at different timing.Methods The clinical data of 49 adult patients with ruptured cerebral aneurysm in our hospital who met the inclusion and exclusion criteria from October 2014 to September 2016 were retrospectively analyzed.They were divided into the early surgery (≤3 days after onset)group (26 cases) and delayed surgery (4-21 days after onset) group (23 cases) according to the timing of clipping.The continuous ICP monitoring and ICP-oriented comprehensive treatment were performed after surgery in both groups.The characteristics and clinical significance of postoperative ICP of patients in two groups were compared and analyzed.The prognosis of the patients in two groups was evaluated by mortality and modified Rankin scale (mRS) score at 12-month follow-up.Results There were no significant differences in imaging characteristics and prognosis between the two groups of patients (P>0.05).The total average postoperative ICP of patients in the early surgery group was (15.21±3.71) mmHg, which was higher than that in the delayed surgery group for (14.12±4.13) mmHg, and the difference was statistically significant (P<0.05).The average postoperative ICP of patients in the early surgery group increased slowly and then decreased, average ICP on the third and fifth days after surgery was higher than that at the first day, with the highest on the fifth day and it decreased on the seventh day after surgery, and was lower than that on the first day after surgery, with statistically significant differences (P<0.05).In the delayed surgery group, the average ICP started to decrease on the second day after surgery, and the average ICP on the sixth and seventh days after surgery was lower than that on the first day, lowest on the seventh day after surgery, with statistically significant differences (P<0.05).There was no significant difference in the average ICP between the two groups on the seventh day after surgery (P>0.05).Conclusion The total postoperative ICP of patients with ruptured cerebral aneurysm who have been operated within 3 days after onset is higher than that of delayed surgery.The postoperative ICP of patients with either early or delayed surgery shows a tendency of increasing first and decreasing then.The ICP reaches the peak on the fifth day after early surgery while that on the second day after delayed surgery.The ICP of patients after clipping at different timing can be reduced to a lower level after treatment.This feature may be helpful for the clinical diagnosis and treatment of increased postoperative ICP in patients with ruptured cerebral aneurysm.

Key words： Cerebral aneurysm Subarachnoid hemorrhage Intracranial pressure monitoring Prognosis

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	Articles by authors
	XU Ya-wen
	FANG Wen-hua
	CAI Jia-wei
	WANG Fang-yu
	LIN Zhang-ya
	LIN Yuan-xiang
	YU Liang-hong
	KANG De-zhi

Cite this article:

XU Ya-wen,FANG Wen-hua,CAI Jia-wei, et al. Study on intracranial pressure monitoring after ruptured cerebral aneurysm clipped at different timing[J]. 中国当代医药, 2020, 27(12): 4-7转28.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I12/4

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