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自发脑内出血患者的脑内压力监测:系统性综述与元分析

Shanshan Duan¹, Qiang Yuan², Meihua Wang¹

¹Department of ICU of Hongqiao Campus, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

World neurosurgery

|July 7, 2024

概括

内压力监测可能会降低自发性脑内出血 (ICH) 的选定患者的死亡率,特别是那些没有心室内出血的患者. 然而,它并不能改善长期的神经功能结果,因此需要进一步研究以进行最佳的患者选择.

科学领域:

神经外科神经外科
神经学神经学
关键护理医学关键护理医学

背景情况:

自发性脑内出血 (ICH) 的死亡率很高.
升高的内压力 (ICP) 是ICH患者不良结果的重要预测因素.
持续ICP监测在改善患者结果中的作用仍然是调查的主题.

研究的目的:

评估内压监测 (ICPM) 对自发性ICH患者的死亡率和功能结果的影响.
确定可能从ICPM中受益的ICH患者的潜在子组.

主要方法:

研究的系统审查和元分析,涉及自发性ICH患者,接受ICPM或不接受ICPM治疗.
主要结局包括住院和6个月死亡率.
二级结局是6个月的神经功能结局.

主要成果:

虽然ICPM显示出减少住院死亡率的趋势,但整体而言,这一趋势在统计学上并不显著.
除了心室内出血病例,ICPM显著降低了住院死亡率.
使用ICPM观察到6个月死亡率显著降低,特别是在没有腹腔内出血的患者中.
在ICPM和没有ICPM组之间没有发现6个月功能结果的显著差异.
升高的ICP与增加的死亡率和较差的功能结果密切相关.

结论:

升高的ICP与增加的死亡率和ICH中更差的预后有关.
在特定的ICH亚组中,ICP监测可能会提供生存益处,但不会增强神经功能.
需要进行进一步的研究,以确定用于ICP监测的最佳患者群体.

关键词:

内压力内压力内压力监测内压力监测死亡率死亡率死亡率自发的脑内出血.

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