Yang Yongbo, Pan Yuchun, Chen Chunlei, Zhao Penglai, Hang Chunhua
Department of Neurosurgery, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China.
Department of Neurosurgery, Nanjing Lishui People's Hospital, Nanjing 211200, China.
J Clin Med. 2022 Jan 28;11(3):671. doi: 10.3390/jcm11030671.
The present study aimed to investigate the clinical significance of multiparameter intracranial pressure (ICP) monitoring in the prediction of the prognosis of hypertensive intracerebral hemorrhage (HICH).
A retrospective analysis was performed on the clinical data of 53 HICH patients. The patients underwent removal of intracranial hemorrhage and decompressive craniectomy after admission. A ventricular ICP monitoring probe was used to continuously and invasively monitor mean arterial pressure (MAP) and ICP after surgery. The NEUMATIC system was used to collect ICP data, including pressure reactivity index (PRx), ICP dose (DICP), amplitude and pressure regression (RAP), and cerebral perfusion pressure (CPP). The mean PRx, CPP, RAP, ICP, and DICP20 mmHg × h were calculated with 1 h as the time segment. According to the Glasgow outcome scale (GOS) scores after discharge, the patients were grouped into the poor prognosis group (GOS I-III) and the good prognosis group (GOS IV and V). The two groups were compared in terms of GOS scores in the treatment and prediction of prognosis of patients.
The good prognosis group showed significantly lower values of mean ICP, DICP20 mmHg × h, RAP, and PRx than the poor prognosis group, while CPP was significantly higher ( < 0.001).
PRx, DICP, RAP, and CPP could reflect intracranial changes in patients and were significantly correlated with the prognosis of the patients. Mean ICP, PRx, DICP20 mmHg × h, and RAP were negatively correlated with prognosis, while CPP was positively correlated with prognosis.
本研究旨在探讨多参数颅内压（ICP）监测在预测高血压性脑出血（HICH）预后中的临床意义。
对53例HICH患者的临床资料进行回顾性分析。患者入院后接受颅内血肿清除术和去骨瓣减压术。术后使用脑室ICP监测探头连续有创监测平均动脉压（MAP）和ICP。采用NEUMATIC系统收集ICP数据，包括压力反应性指数（PRx）、ICP剂量（DICP）、幅度与压力回归（RAP）以及脑灌注压（CPP）。以1小时为时间段计算平均PRx、CPP、RAP、ICP和DICP20 mmHg×h。根据出院后的格拉斯哥预后量表（GOS）评分，将患者分为预后不良组（GOS I - III）和预后良好组（GOS IV和V）。比较两组在患者预后治疗和预测方面的GOS评分。
预后良好组的平均ICP、DICP20 mmHg×h、RAP和PRx值显著低于预后不良组，而CPP显著更高（<0.001）。
PRx、DICP、RAP和CPP可反映患者颅内变化，且与患者预后显著相关。平均ICP、PRx、DICP20 mmHg×h和RAP与预后呈负相关，而CPP与预后呈正相关。
