超声检查视神经鞘直径监测重症颅脑外伤病人颅内压的相关性研究  

Correlation Study on Ultrasonography Examination of Optic Nerve Sheath Diameter for Intracranial Pressure in Patients with Severe craniocerebral trauma

作　　者：凌峻[1] 刘鹏[1] 曾晓英[2] 娄建云[1] 邱传珍[1] 廖伟[1] 郭邦明[1] 

机构地区：[1]赣南医学院第一附属医院神经外科,江西赣州341000 [2]赣南医学院第一附属医院超声科,江西赣州341000

出　　处：《赣南医学院学报》2015年第6期920-923,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省赣州市科技计划项目(GZ2014ZSF082)

摘　　要：目的:探讨超声检查视神经鞘直径(optic nerve sheath diameter,ONSD)在重症颅脑外伤病人颅内压(intracranial pressure,ICP)监测中的作用。方法:选择2014年1月至2015年5月本院重症颅脑损伤患者40例,入院时GCS评分≤8分,随机分成超声检查视神经鞘直径组(A组)和颅内压仪组(B组),入院后至第7天,A组每日测量3次、每眼检查3次,计算全部受检者ONSD平均值,同时记录相同时间A、B组颅内压数据,对所有数据进行统计分析。结果:A组ICP增高的患者ONSD显著高于ICP正常的ONSD(P<0.05),A组和B组在手术及预后方面比较差异没有统计学意义(P>0.5)。结论:重型颅脑损伤病人ONSD随ICP的升高而增大,超声检查ONSD在颅脑损伤诊断中能反应颅内压的升高,是一种无创性,操作方便,简单易学,价格低廉的颅高压评估方法,适宜在基层医院开展。Objective： To explore the effect of ultrasonography examination of optic nerve sheath diameter（ONSD） for intracranial pressure（ICP） in severe traumatic brain injured patients. Methods： From January 2014 to May 2015,40 cases of severe traumatic brain injured patients were chosen as experimental group including uhrasonography examination of optic nerve sheath diameter（ group A） and examination of intraeranial pressure （group B） according to the admission GCS score（GSC≤8）. 7 days after admission, group A was measured 3 times a day, 3 times for each eye; the average of all ONSD was calculated; the intracranialpressure data of group A and B were recorded at the same time; all the data were analyzed statistically. Results ： ONSD of patients with increased ICP in group A was significantly higher than that in normal ICP group （P 〈 0.05 ）, but there was no significant difference on surgery and prognosis between group A and group B （P 〉 0.5 ）. Conclusion： ONSD of severe eraniocerebral injury patients increases with the rise of the ICP. The ultrasonography examination of ONSD can indicate the ICP increase in the diagnosis of craniocerebral injury, which can be used as a non-invasion, simple and feasible approach for evaluation of ICP.

关 键 词：重症颅脑损伤 视神经鞘直径 超声检查 颅内压 

分 类 号：R651.15[医药卫生—外科学]