超声监测视神经鞘直径在成年人颅内压增高患者诊治中的应用  

Application of ultrasound monitoring optic nerve sheath diameter in diagnosis and treatment of adult patients with intracranial hypertension

作　　者：柳成荫[1] 石祥恩[2] 王有全[1] 杨金菊 孙玉明[2] 刘方军[2] 申辉 张福征[1] Liu Chengyin;Shi Xiang′en;Wang Youquan;Yang Jinju;Sun Yuming;Liu Fangjun;Shen Hui;Zhang Fuzheng(Department of Neurosurgery,Beijing Pinggu Hospital,Beijing 101200,China;Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China)

机构地区：[1]北京市平谷区医院神经外科,北京101200 [2]首都医科大学北京三博脑科医院,北京100093

出　　处：《中国医师进修杂志》2022年第5期403-406,共4页Chinese Journal of Postgraduates of Medicine

基　　金：北京市平谷区医院青年人才项目(pgyyqn2019-01)。

摘　　要：目的探讨床旁超声测量视神经鞘直径(ONSD)在成年人颅内压(ICP)升高患者中的作用。方法选取2017年6月至2020年3月北京市平谷区医院放置有创ICP监测探头患者共64例(ICP增高32例,ICP正常32例),持续监测ICP并监测ONSD,另于眼科门诊招募32例健康志愿者作为对照组检查ONSD。观察ONSD与ICP之间的相关性及渗透疗法后ICP与ONSD的变化。结果ICP增高组ONSD显著高于ICP正常组[(5.77±0.3)mm比(5.01±0.1)mm](P<0.05),且ONSD和ICP之间存在正相关,ICP正常组ONSD和对照组ONSD比较差异无统计学意义(P>0.05),渗透治疗后ICP及ONSD均下降。结论超声监测ONSD能够较好地反映ICP增高水平、评估渗透疗法疗效及患者预后。床旁超声检查视神经鞘直径判断ICP及评估渗透治疗疗效具有较高的临床应用价值。Objective To investigate the effect of ultrasound measurement of optic nerve sheath diameter(ONSD)in adult patients with elevated intracranial pressure(ICP).Method From June 2017 to March 2020,A total of 64 patients(32 patients with elevated ICP and 32 patients with normal ICP)were placed with invasive intracranial pressure monitoring probe in Beijing Pinggu Hospital.Their ICP and ONSD were continuously monitored.Thirty-two healthy volunteers were recruited as control group to check ONSD.The correlation between ONSD and ICP,and the changes of ICP and ONSD after osmotic therapy were observed.Results The ONSD in ICP increased group was significantly higher than that in normal ICP group:(5.77±0.3)mm vs.(5.01±0.1)mm,with statistical difference(P<0.05),and there was a positive correlation between ONSD and ICP.There was no significant difference in ONSD between normal ICP group and control group(P>0.05).Conclusions Ultrasound monitoring ONSD can reflect the level of ICP and evaluate the effect of osmotic therapy and the prognosis of patients.Bedside ultrasound examination of optic nerve sheath diameter could be used to judge ICP and to evaluate the curative effect of osmotic therapy,with high clinical application value.

关 键 词：超声检查 多普勒 经颅 视神经 颅内压升高 渗透治疗 

分 类 号：R651.1[医药卫生—外科学] R445.1[医药卫生—临床医学]