超声确定视网膜中央动脉EDV诊断颅脑损伤患者术后低脑灌注压的准确性  

Accuracy of ultrasound-determined end-diastolic velocity of central retinal artery in diagnosing postoperative low cerebral perfusion pressure in patients with craniocerebral trauma

作　　者：虞梦楠 邓岩军 李华[2] 乔世刚 王琛[2] Yu Mengnan;Deng Yanjun;Li Hua;Qiao Shigang;Wang Chen(Department of Anesthesiology and Perioperative Medicine,Suzhou Hospital Affiliated to Nanjing Medical University(Western District),Suzhou 215153,China;Department of Anesthesiology and Perioperative Medicine,Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China)

机构地区：[1]南京医科大学附属苏州医院(西区)麻醉与围术期医学科,215153 [2]南京医科大学附属苏州科技城医院麻醉与围术期医学科,215153

出　　处：《中华麻醉学杂志》2019年第8期982-984,共3页Chinese Journal of Anesthesiology

基　　金：苏州市高新区医疗卫生科技计划重点项目(2016Z002)。

摘　　要：目的评价超声确定视网膜中央动脉舒张末期血流速度(EDV)诊断颅脑损伤患者术后低脑灌注压(CPP)的准确性。方法颅脑损伤患者49例,年龄18~64岁,BMI 18.5~23.9 kg/m^2,性别不限。于术后1 d时采用超声确定视网膜中央动脉收缩期血流速度峰值(PSV)和EDV,记录MAP和颅内压(ICP),计算脑灌注压(CPP)=MAP-ICP。结果EDV与CPP呈正相关(r=0.746,P<0.01);PSV与CPP无相关(P>0.05)。EDV诊断低CPP的ROC曲线下面积为0.938(95%可信区间0.871~1.000),临界值为3.205(灵敏度94.4%,特异度76.9%)。结论超声确定视网膜中央动脉EDV可准确诊断颅脑损伤患者术后低CPP。Objective To evaluate the accuracy of ultrasound-determined end-diastolic velocity(EDV)of central retinal artery(CRA)in diagnosing postoperative low cerebral perfusion pressure(CPP)in the patients with craniocerebral trauma.Methods Forty-nine patients of both sexes with brain injury,aged 18-64 yr,with body mass index of 18.5-23.9 kg/m^2,were enrolled.The peak systolic velocity and EDV of CRA were determined using ultrasound at 1 day after operation.Mean arterial pressure and intracranial pressure were recorded,and CPP was calculated(CPP=mean arterial pressure-intracranial pressure).Results EDV was positively correlated with CPP(r=0.746,P<0.01),and peak systolic velocity was not correlated with CPP(P>0.05).The area under the receiver operating characteristic curve for EDV in diagnosing low CPP was 0.938(95%confidence interval 0.871-1.000),and the critical value was 3.205(sensitivity 94.4%,specificity 76.9%).Conclusion Ultrasound-determined EDV of central retinal artery can accurately diagnose postoperative low CPP in the patients with craniocerebral trauma.

关 键 词：超声检查 视网膜 动脉 血流速度 诊断 颅脑损伤 脑血管循环 

分 类 号：R44[医药卫生—诊断学]