颅内动脉瘤夹闭术后颅内压波形参数的临床价值  

Clinical value of intracranial pressure wave parameters in patients after intracranial aneurysm clipping

作　　者：李辉[1] 黄志坚[1] 文毫[2] 漆凌骏 刘国静 柴伟娜[1] 徐丹[1] 杨小敏[1] 孙晓川[1] LI Hui1, HUANG Zhijian1, WEN Hao2 , QI Linjun1, LIU Guojing1, CHAI Weina1, XU Dan1, YANG Xiaomin1, SUN Xiaochuan1(1Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 2College of Physics, Chongqing University, Chongqing, 400044, Chin)

机构地区：[1]重庆医科大学附属第一医院神经外科,重庆400016 [2]重庆大学物理学院,重庆400044

出　　处：《第三军医大学学报》2018年第7期631-635,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金面上项目(81571159);国家临床重点专科建设经费资助[(2011)170]~~

摘　　要：目的分析颅内压波形参数与患者术后早期临床表现的相关性,探讨颅内动脉瘤夹闭术后颅内压波形参数的临床价值。方法收集2016年11月至2017年7月重庆医科大学附属第一医院神经外科重症监护室颅内动脉瘤夹闭术后使用颅内压(intracranial pressure,ICP)监测的55例患者的临床资料。根据患者ICP植入术后24 h内的ICP数据,使用领域平均振幅算法计算2个ICP波形参数:平均ICP值(mean intracranial pressure,MICP)和平均ICP振幅值(mean intracranial pressure wave amplitude,MWA)。分析MICP、MWA与患者术前病情及术后早期临床表现的关系。结果 (1)患者术前病情较轻者,其术后MICP、MWA越低。(2)根据术后格拉斯哥评分(glasgow coma score,GCS)将患者分为3组(GCS 3~8分,GCS 9~12分,GCS 13~15分),各组间MICP和MWA差异均有统计学意义(P<0.05)。(3)术后GCS评分与MICP(r=-0.619,P<0.05)、MWA(r=-0.782,P<0.05)呈负相关,且MWA与GCS评分相关性更强。结论 ICP波形参数MICP、MWA能有效地反映颅内动脉瘤夹闭术后早期患者的神经功能障碍。Objective To analyze the correlation between the parameters of intracranial pressure wave and early clinical manifestations in the patients after intracranial aneurysm clipping, and investigate the clinical value of these parameters. Methods Clinical data of 55 patients with full data on intracranial pressure （ICP） after intracranial aneurysm clipping in our neurosurgical department from November 2016 to July 2017 were collected in this study. According to the ICP results within 24 h after implantation, 2 ICP parameters, mean intracranial pressure （MICP） and mean intracranial pressure wave amplitude （MWA） were calculated by area average amplitude algorithm. The correlations of MICP and MWA with the preoperative conditions and postoperative clinical manifestations were analyzed. Results ①For the patients with milder preoperative conditions, they had lower MICP and MWA after operation. ②When the patients were divided into 3 groups based on Glasgow coma score （GCS, 3~8, 9~12 and 13~15 points respectively）, significant differences were seen in MWA and MICP among different GCS groups （P〈0.05）. ③There were negative correlation of postoperative GCS score with MICP （r=-0.619, P〈0.05） and MWA （r=-0.782, P〈0.05）, with MWA more significant. Conclusion ICP wave parameters, MWA and MICP, both can effectively indicate early nervous dysfunction in patients after intracranial aneurysm clipping.

关 键 词：颅内动脉瘤夹闭 颅内压 颅内压振幅 

分 类 号：R181.32[医药卫生—流行病学] R741.044[医药卫生—公共卫生与预防医学]