Clinical Application Of Noninvasive Cerebral Edema Monitor In Hypertensive Intracerebral Hemorrhage

Background:With China's economic development and the aging population trend increasing,the incidence of hypertensive cerebral hemorrhage is getting higher and higher in China,and its mortality and disability rate are also increasing,bringing a huge burden on society and family.Improving the diagnosis,and treatment of hypertensive cerebral hemorrhage,reducing complications,and improving patient prognosis are of great significance for reducing burdens of family and society.Objective:To continuously monitor the change of the disturbance coefficient of patients with hypertensive cerebral hemorrhage through a noninvasive cerebral edema dynamic monitor,to explore the application of noninvasive cerebral edema dynamic monitor to patients with cerebral hemorrhage,to evaluate the severity of brain injury after cerebral hemorrhage;to regulate the dosage and use of dehydration drugs Course of treatment;evaluate the treatment effect and prognosis,and study the clinical significance of noninvasive brain edema monitoring in the treatment of hypertensive cerebral hemorrhage.Methods:1.Randomly selected patients with hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery,the Second Affiliated Hospital of Xi'an Medical College from September 2018 to September 2019,the screening criteria:1).All were diagnosed as high Blood pressure and cerebral hemorrhage by CT and clinical diagnosis;2).10ml<hematoma volume<120ml(calculate hematoma volume according to Tada's formula);3).GCS score:3-15 points;4).Age greater than 30 years old,less than 90 years old;exclusion factor:brain injury,Cerebral aneurysm,vascular malformation,tumor,coagulopathy,cerebral hemorrhage,tumor stroke hemorrhage;pregnancy,lactation patients;severe heart,lung,liver and kidney dysfunction patients.2.Randomly divided 160 patients into a test group(N=80)and a control group(N=80).Both patients underwent routine basic treatment after admission,including ECG monitoring,blood pressure control,hemostasis,nutritional nerves,and prevention Sexual application of antibiotics and maintenance of homeostasis,diet,nutritional support,etc.The routine group empirically used the dehydrating drug mannitol,and the treatment group guided the use of mannitol or adjusted the treatment plan according to the noninvasive brain edema monitoring value.3.Compared the length of hospital stay,average daily mannitol usage,days of use,and prognosis difference between the two groups of patients(to understand the prognosis of patients by telephone visit and outpatient follow-up in half a year),lung infection,electrolyte disturbance,renal impairment,stress The incidence of sexual ulcers.The clinical efficacy of noninvasive brain edema dynamic monitoring in the treatment of hypertensive cerebral hemorrhage was analyzed,and its clinical application value was discussed.Results:The average daily dosage of mannitol in the test group was(283.1 ± 93.6)ml,the duration of using was(11.8 ± 4.2)days,and the duration of hospitalization was(23.9 ± 8.3)days.After six months of discharge,the follow-up GOS score:good 32 Cases(40%),generally 36 cases(45%),and very poor 12 cases(15%)are shown in Table 5.Complications:18 cases of lung infection(22.5%),6 cases of electrolyte disturbance(7.5%),2 cases of renal impairment(2.5%),15 cases of stress ulcer(18.8%),Table 3.The average daily dosage of mannitol in the control group was(362.7 ± 117.7)ml,the number of days of use was(14.8 ± 5.2)days,and the number of days of hospitalization was(29.4 ± 7.9)days.After six months of discharge,the follow-up GOS score:20 good 25%),generally 26 cases(32.5%),very poor 34 cases(42.5%),see Table 5.Complications:20 cases(25%)of lung infection,30 cases(37.5%)of electrolyte disturbance,20 cases(25%)of renal impairment,and 16 cases(20%)of stress ulcers,Table 3.Conclusion:For patients with hypertensive cerebral hemorrhage,continuous noninvasive cerebral edema dynamic monitoring can assess the severity of brain injury after hemorrhage,guide the use of dehydration drugs,reduce complications,shorten hospital stay,improve prognosis,and can be used as a new adjuvant treatment method.