Effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state
10.3760/cma.j.cn211501-20191126-03500
- VernacularTitle:脑出血患者静息状态下不同头位抬高角度对颅内压和脑血流量的影响
- Author:
Yan JIANG
1
;
Ping YUAN
;
Yanru ZHANG
;
Bo XU
Author Information
1. 南京大学医学院附属鼓楼医院神经外科 210000
- From:
Chinese Journal of Practical Nursing
2020;36(22):1700-1704
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state, to provide scientific basis for nursing development.Methods:A total of 72 hypertensive cerebral hemorrhage patients were selected as research subject, at the resting state, head elevation was raised up with 0°, 5°, 10°, 15°, 20°, 25°, 30° in the supine position with 5 minutes interval between different positions. The levels of intracranial pressure, cerebral perfusion pressure, regional oxygen saturation, blood pressure, heart rate, pulse oxygen saturation were recorded.Results:With head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the levels of intracranial pressure were (12.39±3.32), (10.64±3.19), (9.84±2.58), (9.09±1.76), (8.33±2.51), (7.13±1.81), (6.81±1.67) mmHg(1 mmHg=0.133 kPa); mean arterial pressure were (106.06±10.17), (104.45±10.77), (105.87±6.73), (106.82±10.36), (105.78±10.27), (106.77±6.15), (100.30±10.92) mmHg; cerebral perfusion pressure were (93.67±10.36), (93.82±10.81), (96.03±7.26), (97.73±10.63), (97.45±10.38), (99.65±6.62), (93.49±10.99) mmHg; regional oxygen saturation were (65.91±6.70)%, (66.89±6.52)%, (67.12±8.04)%, (69.33±13.26)%, (69.31±8.47)%, (68.94±9.82)%, (66.12±6.78)%. Intracranial pressure was increased gradually with head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the difference was statistically significant ( F value was 45.380, P<0.01). Mean arterial pressure was significantly decreased at 30° head elevation compared to the 0°, 5°, 10°, 15°, 20°, 25° head elevation ( t values were 2.331-2.997, P<0.05). Cerebral perfusion pressure and regional oxygen saturation showed an increased trend, however, those index was decreased at 30° head elevation, the levels of cerebral perfusion pressure and regional oxygen saturation was significantly increased at 15°, 20°, 25° head elevation compared to the 0° and 30° head elevation ( t values were 2.554-3.331 and 2.378-3.091, P<0.05). However, there was no significant difference between 0°, 5°, 10°, 15°, 20°, 25°, 30° head elevation in systolic pressure, diastolic pressure, heart rate, pulse oxygen saturation ( P>0.05). Conclusions:15°-25° head elevation is a relatively appropriate position in patients with hypertensive cerebral hemorrhage.