重症开颅术后患者的体位护理对颅内压、平均动脉压及脑灌注压的影响(1)
[摘要]目的 探討重症开颅术后患者的体位护理对颅内压(ICP)、平均动脉压(MAP)及脑灌注压(CPP)的影响。方法 选取2015年3月～2016年2月于我院接受开颅术治疗的重症颅脑损伤患者40例。所有患者均进行0°、10°、20°、30°以及40°体位的改变，分别比较不同体位时患者的ICP、MAP及CPP，并作相关性分析。结果 患者体位在0～40°时ICP水平呈逐渐下降趋势，差异有统计学意义(P<0.05)。患者体位在0～40°时MAP水平呈逐渐下降趋势，差异有统计学意义(P<0.05)。患者体位在0～30°时CPP水平分别为(69.7±5.5)、(70.2±4.4)、(71.1±3.9)和(74.5±3.6)mmHg，呈逐渐上升趋势，而体位在40°时患者CPP为(63.5±3.5)mmHg，显著低于0～30°时的CPP，差异均有统计学意义(t=6.015，P=0.000；t=7.537，P=0.000；t=9.173，P=0.000；t=13.856，P=0.000)。经相关性分析，体位与重症开颅术后患者ICP、MAP均呈显著负相关关系(r=0.732，P=0.000；r=0.757，P=0.000)。结论 体位护理对重症开颅术后患者的ICP、MAP以及CPP均有一定影响，其中体位为30°～40°时患者ICP与MAP水平可能存在明显下降，同时CPP水平上升，有利于患者预后。
[关键词]重症；体位；颅内压；平均动脉压；脑灌注压
[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721(2017)04(a)-0172-03
Influence of posture nursing on intracranial pressure，mean arterial pressure and cerebral perfusion pressure in patients with critical conditions undergone craniotomy
SUN Jie LIU Bing-lan LEI Yuan-hua
Department of Surgery Ward Two，the Second People′s Hospital，Shenzhen Baoan People′s Hospital (Group) in Guangdong Province，Shenzhen 518108，China
[Abstract]Objective To explore the influence of posture nursing on intracranial pressure (ICP)，mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) in patients with severe conditions undergone craniotomy.Methods A total of 40 patients with severe craniocerebral injury who were provided with craniotomy from March 2015 to February 2016 were selected.All patients were nursed in 0°，10°，20°，30° and 40° postures.The ICP， MAP and CPP were compared in different positions，and the correlation analysis was performed.Results The level of ICP was gradually decreased ranging from 0° to 40°with statistical differences (P<0.05).The MAP level was also decreased gradually at 0° to 40°，which was displayed statistical differences (P<0.05).The levels of CPP was (69.7±5.5)，(70.2±4.4)，(71.1±3.9)，(74.5±3.6) mmHg were gradually increased at 0° to 30°.At 40°，the level of CPP was(63.5±3.5) mmHg，significantly lower than those at 0° to 30° with statistical differences (t=6.015，P=0.000；t=7.537，P=0.000；t=9.173，P=0.000；t=13.856，P=0.000).By correlation analysis，posture was in great negative correlation with ICP and MAP in patients with critical conditions after craniotomy (r=0.732，P=0.000；r=0.757，P=0.000).Conclusion Posture nursing has a certain influence on the levels of ICP，MAP，and CPP in patients with critical conditions undergone craniotomy.Among them，posture at 30°to 40°，the levels of ICP and MAP are both decreased，and CPP is in rise simultaneously，which is beneficial to patient′s prognosis. (孙杰 刘炳兰 雷员华)
[关键词]重症；体位；颅内压；平均动脉压；脑灌注压
[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721(2017)04(a)-0172-03
Influence of posture nursing on intracranial pressure，mean arterial pressure and cerebral perfusion pressure in patients with critical conditions undergone craniotomy
SUN Jie LIU Bing-lan LEI Yuan-hua
Department of Surgery Ward Two，the Second People′s Hospital，Shenzhen Baoan People′s Hospital (Group) in Guangdong Province，Shenzhen 518108，China
[Abstract]Objective To explore the influence of posture nursing on intracranial pressure (ICP)，mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) in patients with severe conditions undergone craniotomy.Methods A total of 40 patients with severe craniocerebral injury who were provided with craniotomy from March 2015 to February 2016 were selected.All patients were nursed in 0°，10°，20°，30° and 40° postures.The ICP， MAP and CPP were compared in different positions，and the correlation analysis was performed.Results The level of ICP was gradually decreased ranging from 0° to 40°with statistical differences (P<0.05).The MAP level was also decreased gradually at 0° to 40°，which was displayed statistical differences (P<0.05).The levels of CPP was (69.7±5.5)，(70.2±4.4)，(71.1±3.9)，(74.5±3.6) mmHg were gradually increased at 0° to 30°.At 40°，the level of CPP was(63.5±3.5) mmHg，significantly lower than those at 0° to 30° with statistical differences (t=6.015，P=0.000；t=7.537，P=0.000；t=9.173，P=0.000；t=13.856，P=0.000).By correlation analysis，posture was in great negative correlation with ICP and MAP in patients with critical conditions after craniotomy (r=0.732，P=0.000；r=0.757，P=0.000).Conclusion Posture nursing has a certain influence on the levels of ICP，MAP，and CPP in patients with critical conditions undergone craniotomy.Among them，posture at 30°to 40°，the levels of ICP and MAP are both decreased，and CPP is in rise simultaneously，which is beneficial to patient′s prognosis. (孙杰 刘炳兰 雷员华)