无创脑电阻抗测定动态监测蛛网膜下腔出血后脑水肿的临床研究  

Application of noninvasive cerebral electrical impedance measurement in monitoring brain edema after subarachnoid hemorrhage:report of 46 cases

作　　者：陈慧[1] 王健[1] 董为伟[2] 毛思中[1] 

机构地区：[1]重庆医科大学附属第二医院神经内科,重庆400010 [2]重庆医科大学附属第一医院神经内科,重庆400016

出　　处：《第三军医大学学报》2010年第15期1656-1659,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金(50337020)~~

摘　　要：目的初步评价无创脑电阻抗(cerebral electrical impedance,CEI)测定在蛛网膜下腔出血(subarachnoidhemorrhage,SAH)患者脑水肿监测中的应用价值。方法对发病后3 d内的46例SAH患者,采用50 kHz及0.1 mA的刺激电流进行连续CEI测定。以扰动系数(perturbative index,PI)表示CEI测定结果,PI值大于9.5,或连续3次或3次以上病灶侧与对侧的PI之差大于0.3定义为CEI异常。结果 21.7%(10/46)患者首次测定时发现双侧CEI明显升高,PI>9.5,其中7例头部CT显示全脑水肿,另3例头部CT未显示脑水肿;其余36例首次测定时CEI在正常范围,头部CT均未显示脑水肿。间隔3 d后,CEI检测发现有5例患者PI值升高明显,复查CT显示脑水肿。结论 CEI检测可较敏感地反映SAH患者脑水肿的存在,有助于及时判断病情和指导治疗。Objective To evaluate the application of noninvasive cerebral electrical measurement in monitoring brain edema after subarachnoid hemorrhage （SAH）. Methods impedance （CEI） CEI was measured in 46 SAH patients stimulated with an invariable secure current at a frequency of 50 kHz and an intensity of 0. 1 mA within 3 d after onset of the disease. CEI was expressed as the perturbative index （PI）. CEI was defined as abnormal when P! was over 9.5 or the difference in PI was over 0.3 for 3 or more 3 measurements of PI in loci and bilateral side. Results The CEI was significantly increased in 10 patients （21.7%） with their PI 〉9.5. Among the 10 patients, CT showed global cerebral edema in 7 and no cerebral edema in 3. The CEI was within the normal range in the remaining 36 patients with no obvious cerebral edema. The PI was signifi- candy increased in 5 SAH patients with obvious cerebral edema in 3 d after onset of the disease. Conclusiorl CEI measurement can sensitively show cerebral edema in SAH patients, and judge the condition of patients and adjust their treatment.

关 键 词：脑电阻抗 蛛网膜下腔出血 脑水肿 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R742.7[医药卫生—临床医学]