重症超声动态实时监测视神经鞘直径监测颅脑外伤患者颅内压  

Ultrasound Examination of Optic Nerve Sheath Diameter to Monitor Intracranial Pressure in Traumatic Brain Injury

作　　者：吴超瑜 欧阳奕安 岳霖琳 薛正彪 欧阳松茂[1] 施金 朱宏泉[1] WU Chao-yu;OUYANG Yi-an;YUE Lin-lin;XUE Zheng-biao;OUYANG Song-mao;SHI Jin;ZHU Hong-quan(The First Affiliated Hospital of Gannan Medical College,Jiangxi Ganzhou 341000)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《深圳中西医结合杂志》2021年第16期84-86,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江西省卫生健康委科技计划项目资助课题(skjp220203815)。

摘　　要：目的:分析重症超声动态实时监测视神经鞘直径(ONSD)与重症颅脑外伤患者颅内压(ICP)的相关性。方法:研究对象为赣南医学院第一附属医院在2020年1月至2021年2月期间接诊的40例重度颅脑损伤患者,将其随机分为观察组与对照组,每组20例,观察组采取重症超声动态监测ONSD变化;对照组采取重症超声动态监测ONSD变化结合脑室内置管测压法,记录两组患者ONSD变化以及患者ICP结果。结果:对照组患者中,相同时间点下ICP增高者较ICP正常者的ONSD均明显更高,差异具有统计学意义(P<0.05);患者的ICP与ONSD呈正相关(r=0.748,P<0.05);两组患者相同时间点的ONSD比较,差异均无统计学意义(P>0.05);两组患者的生存率比较,差异无统计学意义(P>0.05)。结论:重症超声检查ONSD可作为判断重症颅脑外伤患者ICP的重要依据,ONSD明显增加提示患者ICP在增加,需要及时采取干预措施。Objective To analyze the correlation between the optic nerve sheath diameter(ONSD)and intracranial pressure(ICP)in patients with severe traumatic brain injury.Methods The subjects of the study were 40 patients with severe head injury admitted to the First Affiliated Hospital of Gannan Medical College between January 2020 and February 2021.They were randomly divided into observation group and control group,with 20 cases in each group The observation group used critical ultrasound to dynamically monitor the changes of ONSD;the control group used critical ultrasound to dynamically monitor the changes of ONSD combined with intraventricular tube pressure measurement to record the changes of ONSD and the results of patients'ICP in the two groups.Results In the control group,those with elevated ICP at the same time point had significantly higher ONSD than those with normal ICP,and the difference was statistically significant(P<0.05);patients’ICP and ONSD were positively correlated(r=0.748,P<0.05);There was no statistically significant difference in ONSD between the two groups of patients at the same time point(P>0.05);the difference in survival rates between the two groups of patients was not statistically significant(P>0.05).Conclusion The ONSD of critically ill ultrasound can be used as an important basis for judging the ICP of patients with severe craniocerebral injury.The obvious increase of ONSD indicates that the ICP of patients is increasing,and timely intervention measures are needed.

关 键 词：重症颅脑外伤 重症超声检查 视神经鞘直径 颅内压 相关性 

分 类 号：R774.6[医药卫生—眼科] R770.43[医药卫生—临床医学]