闪光视觉诱发电位无创颅内压监测指导治疗高血压脑出血的作用评估  

Evaluation on the curative effect of FVEP non-invasive ICP monitoring in patients with hypertensive intracerebral hemorrhage

作　　者：何英超 田雪涛[1] 贾松 林燕 牛苗苗 吴萍 HE Yingchao;TIAN Xuetao;JIA Song;LIN Yan;NIU Miaomiao;WU Ping(The Second Central Hospital of Baoding,Baoding 072750,China)

机构地区：[1]保定市第二中心医院,河北保定072750

出　　处：《中国实用神经疾病杂志》2022年第4期448-452,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨视神经鞘直径(ONSD)联合鹿特丹CT评分评估闪光视觉诱发电位(FVEP)无创颅内压(ICP)监测指导治疗高血压脑出血(HICH)患者的价值。方法选取2020-05—2021-05保定市第二中心医院应用FVEP无创ICP监测指导治疗的59例HICH患者,其中治愈组49例,残疾组10例,分析2组患者治疗前后ONSD、鹿特丹CT评分,采用受试者工作特征曲线(ROC)分析ONSD、鹿特丹CT评分对疗效的评估价值。结果治疗前治愈组与残疾组患者ICP值[(196.40±16.11)mmHg、(201.33±20.13)mmHg]及住院时间[(7.13±1.35)d、(7.86±1.23)d]比较差异无统计学意义(P>0.05),治愈组患者出血量[(24.83±1.27)mL]低于残疾组[(26.49±3.18)mL],治疗后出院时2组ICP值均明显降低,且治愈组[(154.94±13.50)mmHg]低于残疾组[(173.04±13.36)mmHg](P<0.05)。治疗前治愈组与残疾组患者的ONSD[(5.34±0.55)mm、(5.11±0.74)mm]、鹿特丹CT评分[(4.73±0.19)分、(4.81±0.13)分]比较差异无统计学意义(P>0.05),治疗后两项指标均明显降低,且治愈组[(2.97±0.36)分]低于残疾组[(4.01±0.44)分](P<0.05)。Pearson相关分析显示,治疗后ONSD、鹿特丹CT评分与出院时ICP值均呈正相关(r=0.569、0.588,P<0.05)。ROC曲线分析显示,治疗后ONSD、鹿特丹CT评分单独及联合检测评估疗效的AUC分别为0.790、0.714、0.816(P<0.05)。结论ONSD联合鹿特丹CT评分对FEVP无创ICP监测指导治疗HICH的效果有较好的评估价值。Objective To explore the value of optic nerve sheath diameter(ONSD)combined with Rotterdam CT score in evaluating the curative effect of flash visual evoked potential(FVEP)non-invasive intracranial pressure(ICP)monitoring in patients with hypertensive intracerebral hemorrhage(HICH).Methods A retrospective selection was performed on the 59 patients with HICH treated under the guidance of FVEP non-invasive ICP monitoring in the Second Central Hospital of Baoding between May 2020 and May 2021.According to clinical curative effect,they were divided into healing group(49 cases)and disability group(10 cases).ONSD and Rotterdam CT scores before and after treatment between the two groups were compared.The evaluation value of ONSD and Rotterdam CT score for curative effect was analyzed by receiver operating characteristic(ROC)curves.Results Before treatment,there was no significant difference in ICP((196.40±16.11)mmHg vs(201.33±20.13)mmHg)or hospitalization time((7.13±1.35)d vs(7.86±1.23)d)between healing group and disability group(P>0.05).The blood loss in healing group was less than that in disability group((24.83±1.27)mL vs(26.49±3.18)mL).After treatment,ICP in both both groups was significantly reduced,which was lower in healing group than disability group((154.94±13.50)mmHg vs(173.04±13.36)mmHg)(P<0.05).Before treatment,there was no significant difference in ONSD((5.34±0.55)mm vs(5.11±0.74)mm)or Rotterdam CT score((4.73±0.19)points vs(4.81±0.13)points)between healing group and disability group(P>0.05).After treatment,ONSD or Rotterdam CT score in both groups were significantly decreased,which were lower in healing group than disability group((2.97±0.36)points vs(4.01±0.44)points)(P<0.05).The results of Pearson correlation analysis showed that ONSD and Rotterdam CT score after treatment were positively correlated with ICP at discharge(r=0.569,0.588,P<0.05).The results of ROC curve analysis showed that AUC values of ONSD,Rotterdam CT score and combined detection for evaluating curative effect were 0.790,0

关 键 词：高血压脑出血 视神经鞘宽度 鹿特丹CT评分 闪光视觉诱发电位 无创颅内压 

分 类 号：R743.34[医药卫生—神经病学与精神病学]