【摘要】 目的 探讨围术期颅内压监测指导治疗对高血压脑出血手术患者神经功能恢复及预后的影响。方法 选取2023年1月至2024年6月本院收治的60例高血压脑出血患者为研究对象，采用随机数字表法分为对照组和观察组，每组30例。对照组围术期采用常规治疗，观察组围术期采用颅内压监测指导治疗。比较两组的神经功能恢复情况、血压、血肿残留量、并发症发生情况及预后情况。结果 术后第7、14天，两组的美国国立卫生研究院卒中量表（NIHSS）评分均低于术前，且术后第14天低于术后第7天（P<0.05）；术后第7、14天，观察组的NIHSS评分低于对照组（P<0.05）；经重复测量方差分析显示，两组患者NIHSS评分的时间、组间及交互效应比较，差异具有统计学意义（P<0.05）。术后第7天，观察组的收缩压、舒张压、血肿残留量低于对照组（P<0.05）。观察组的并发症总发生率低于对照组（P<0.05）。术后6个月，观察组的格拉斯哥预后量表（GOS）评分高于对照组，差异具有统计学意义（P<0.05）。结论 围术期颅内压监测指导治疗可显著改善高血压脑出血手术患者的神经功能恢复，有效控制血压，减少血肿残留，降低并发症发生率，改善患者远期预后。更多还原

【Abstract】 Objective To investigate the effects of perioperative intracranial pressure monitoring guided treatment on neurological function recovery and prognosis in patients with hypertensive hemorrhage undergoing surgery. Methods A total of 60 patients with hypertensive hemorrhage admitted to our hospital from January 2023 to June 2024 were selected as the research objects. The patients were divided into control group and observation group by random number table method, with 30 cases in each group. The control group was given routine treatment during the perioperative period, and the observation group was given intracranial pressure monitoring guided treatment during the perioperative period. The recovery of neurological function, blood pressure, residual hematoma, complications and prognosis were compared between the two groups. Results On the 7 th and 14 th day after operation, the National Institutes of Health Stroke Scale(NIHSS) score of the two groups was lower than that before operation, and that on the 14 th day after operation was lower than the 7 th day after operation(P<0.05); on the 7 th and 14 th day after operation,the NIHSS score of the observation group was lower than that of the control group(P<0.05); repeated measures analysis of variance showed that there were statistically significant differences in the time, group and interaction effects of the NIHSS score between the two groups(P<0.05). On the 7 th day after operation, the systolic blood pressure, diastolic blood pressure and residual hematoma volume in the observation group were lower than those in the control group(P<0.05). The total incidence of complications in the observation group was lower than that in the control group(P<0.05). At 6 months after operation, the Glasgow Outcome Scale(GOS) score of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Perioperative intracranial pressure monitoring guided treatment can significantly improve the recovery of neurological function in patients with hypertensive hemorrhage undergoing surgery, effectively control blood pressure, reduce hematoma residue and the incidence of complications, improve the long-term prognosis of patients.更多还原