| Objective: Large area cerebral infarction is an ischemic stroke disease caused by internal carotid artery-middle cerebral artery occlusion with high mortality,high disability rate and high cost.With the rapid development of society,it has gradually become a major problem threatening people’s life,health and safety.For large area cerebral infarction patients,if not timely to find and intervene in the cerebral edema caused by cranial pressure,will seriously affect the clinical curative effect and prognosis of patients with invasive intracranial pressure monitoring can continuous dynamic intracranial pressure monitoring in patients with large area cerebral infarction,help clinical physicians for patients with intracranial pressure situation,so as to timely adjust clinical treatment,In order to improve the clinical efficacy of patients.The main purpose of this study is to study the clinical value of intracranial pressure monitoring in patients with large area cerebral infarction by comparing the timing of surgical treatment and the application of dehydration drugs between the intracranial pressure monitoring group and the group without intracranial pressure monitoring.Methods: Of yanan university hospital neurological intensive medicine between January 2018 and September 2021 were up to the standard of diagnosis,this research into,elimination of 53 patients with large area cerebral infarction were retrospectively analyzed,according to whether the admission line within 24 h emergency bedside ventricle type intracranial pressure probe surgery were divided into observation group and control group,32 cases were 21 cases.The observation group and the control group were given comprehensive cranial pressure lowering measures after admission,and decompression of bone flap was performed when there were surgical indications.In the observation group,intracranial pressure was used to guide the timing of craniectomy decompression surgical treatment and the application of dehydrated hypotensive drugs in patients with large area cerebral infarction.In the control group,clinical manifestations and imaging findings were used to guide the timing of craniectomy decompression surgical treatment and the application of dehydrated hypotensive drugs.The general information of the two groups,indicators,recovery indicators,use of dehydration drugs,complications and prognosis of the observation group after ICP monitoring were compared and analyzed.Results:1.Comparison of general data between the two groups: There were no significant differences in gender,age,cerebral hemisphere infarction area,dominant cerebral hemisphere infarction,history of hypertension,history of diabetes,history of atrial fibrillation,history of stroke,history of smoking,admission GCS score,admission NIHSS score,admission Barthel index and admission midline shift between 2 groups（P > 0.05）.2.Comparison of indexes between the observation group and the two groups after ICP monitoring: preoperative GCS score,preoperative midline shift,preoperative dilated pupil of the affected side,and preoperative disappearance of light reflection of the affected side in the observation group were better than those in the control group（P <0.05）.3.Comparison of recovery indexes between the two groups: GCS,NIHSS and Barthel of the observation group were better than those of the control group at 7 and 30 days after admission（P < 0.05）.4.Comparison of dehydration drug use between the two groups: 20% mannitol daily use in the observation group was better than that in the control group within 1 week after admission（P < 0.05）.5.Comparison of complications between the two groups: renal function injury and electrolyte disorder in the observation group were better than those in the control group（P < 0.05）,but there were no significant differences in stress ulcer,pulmonary infection and intracranial infection between the two groups（P > 0.05）.6.Comparison of prognosis between the two groups: the mortality of patients in the observation group at 1 month after admission was lower than that in the control group（P< 0.05）,and there were no significant differences in the rates of severe disability and good 1 month after admission and the mortality,severe disability and good 6 months after admission between the two groups（P > 0.05）.Conclusion:1.Continuous invasive intracranial pressure monitoring can make the surgical treatment time of patients with large cerebral infarction more timely.2.Continuous invasive intracranial pressure monitoring can reduce the application of dehydration drugs in patients with large area cerebral infarction,and reduce the incidence of complications such as renal function injury and electrolyte disorder.3.Continuous invasive intracranial pressure monitoring can reduce the short-term mortality of patients with massive cerebral infarction,but does not significantly improve the long-term prognosis. |
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