Application of oxygen saturation monitoring of brain tissue combined with continuous intracranial pressure monitoring in the operation of patients with cerebral hemorrhage
10.3760/cma.j.cn101721-20200407-00040
- VernacularTitle:脑组织氧饱和度监测联合持续颅内压监测在脑出血患者手术中的应用
- Author:
Zhong WANG
1
;
Xiaojun ZHANG
;
Jin′gang BAO
;
Zhitong HAN
;
Junqing WANG
;
Rile WU
;
Yisong ZHANG
;
Weiping ZHAO
;
Ruijian ZHANG
Author Information
1. 内蒙古自治区人民医院神经外科 呼和浩特 010017
- Keywords:
Hypertensive intracerebral hemorrhage;
Intracranial pressure;
Near-infrared spectroscopy technology;
Regional cerebral oxygen saturation;
Prognosis
- From:
Clinical Medicine of China
2021;37(5):406-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of continuous intracranial pressure (ICP) combined with regional cerebral oxygen saturation (rScO 2) monitoring in patients with hypertensive intracerebral hemorrhage before and after operation of the removal hematoma through small bone window and the effect on the prognosis of patients. Methods:The clinical data of 37 patients with supratentorial hypertensive intracerebral hemorrhage admitted to the neurosurgical intensive care unit of the people′s Hospital of Inner Mongolia Autonomous Region from April 2018 to October 2020 were retrospectively analyzed.ICP monitoring and near infrared spectroscopy (NIRS) were used to monitor the intracranial pressure and rScO 2 concentration before and after the operation, and the changes of intracranial pressure and rScO 2 before and after the operation were analyzed.According to Glasgow Outcome Score (GOS), patients with GOS score>3 were classified as good prognosis group (21 cases), and those with GOS score ≤3 were classified as poor prognosis group (16 cases). Results:The postoperative intracranial pressure((15.80±6.70) mmHg)of patientswith hypertensive intracerebral hemorrhage was lower than that before operation((20.40±5.80) mmHg), and the difference was statistically significant( t=3.226, P=0.002). The postoperative rScO 2 ((62.31±3.85)% )of patientswith hypertensive intracerebral hemorrhage was higher than that before operation((59.73±3.13)%), and the difference was statistically significant( t=3.171, P=0.002). The decrease of intracranial pressure in patients with good prognosis((6.53±2.21) mmHg)was more obvious than that in patients with poor prognosis((4.24±2.30) mmHg). The concentration of rScO 2 increased in both groups.But in the group with good prognosis, the rScO 2 increased((3.99±2.34)%)was significantly higher than that in poor prognosis group((2.32±2.25)%). Six months after operation, there were significant differences in preoperative and postoperative intracranial pressure and rScO 2 between good prognosis group and poor prognosis group, and the difference was statistically significant( t=3.090, 2.176; P=0.004, 0.036). Conclusion:Small bone window evacuation of intracerebral hematoma can significantly reduce the concentration of intracranial pressure and increase the concentration of rScO 2 in patients with intracerebral hemorrhage.The changes of intracranial pressure and rScO 2 before and after operation have potential value in judging the prognosis of patients.
