无创颅内压监测在颅内感染中的应用  

Application of noninvasive intracranial pressure monitoring in intracranial infection

作　　者：张瑜[1] 于芳苹 赵迎春[1] ZHANG Yu;YU Fangping;ZHAO Yingchun(Department of Neurology,Songjiang Hospital Affiliated to Shanghai JiaoTong University,Shanghai 201699,China;Department of Cadre,Songjiang Hospital Affiliated to Shanghai JiaoTong University,Shanghai 201699,China)

机构地区：[1]上海交通大学附属松江区中心医院神经内科,上海201699 [2]上海交通大学附属松江区中心医院干部科,上海201699

出　　处：《重庆医学》2023年第S01期46-48,共3页Chongqing medicine

基　　金：FVEP无创颅内压监测高血压性脑出血临床研究(16411973000)。

摘　　要：目的探讨闪光视觉诱发电位(FVEP)无创颅内压监测技术在颅内感染中的临床应用价值。方法选取2016年1月至2017年12月该院收治的52例中枢神经系统感染患者为研究对象,其中病毒性脑炎40例,结核性脑炎5例,化脓性脑炎7例。所有病例经FVEP监测颅内压后立即进行腰穿检查,对比腰穿及无创颅内压监测结果。并对颅内压升高患者,静脉滴注甘露醇治疗后的各时间段(10、20、30、40、50、60、120、180、240 min)进行无创颅内压监测。结果FVEP监测获得的颅内压结果(169.96±45.87)mmH_(2)O,腰椎穿刺所得结果(173.80±68.82)mmH_(2)O,差异无统计学意义(t=0.356,P=0.724),但两者呈正相关(r=0.496,P<0.05)。FVEP显示颅内压从甘露醇滴注结束后20 min颅内压开始下降,30 min有差异,60 min颅内压下降明显,120、180 min逐渐回升(P<0.05),240 min回到原点(P>0.05)。结论应用FVEP在中枢神经系统感染中可以准确安全判定颅内压,指导临床脱水剂使用。Objective To study the clinical application value of noninvasive intracranial pressure monitoring technology of flash visual evoked potential(FVEP)in intracranial infection.Methods A total of 52 patients with central nervous system infection admitted to this hospital from January 2016 to December 2017 were selected,ranging from 18 years old to 50 years old.Among them,there were 40 cases of viral encephalitis,5 cases of tuberculous encephalitis and 7 cases of suppurative encephalitis.All cases were examined by lumbar puncture immediately after intracranial pressure was monitored by FVEP,and the monitoring results of lumbar puncture and non-invasive intracranial pressure were compared.Noninvasive intracranial pressure monitoring was conducted for patients with increased intracranial pressure at all time periods(10,20,30,40,50,60,120,180,240 min)after the treatment with static drops of mannitol.Results There was no significant difference between the results of intracranial pressure(169.96±45.87)mmH_(2)O and those of lumbar puncture(173.80±68.82)mmH_(2)O(t=0.356,P=0.724),but they were positively correlated(r=0.496,P<0.05).FVEP showed that the intracranial pressure began to decrease at 20 min after the end of mannitol infusion,and there was a difference at 30 min.The intracranial pressure decreased significantly at 60 min,gradually increased at 120 and 180 min(P<0.05),and returned to the origin at 240 min(P>0.05).Conclusion The application of flash vision evoked potential technology in central nervous system infection can accurately and safely determine intracranial pressure and guide the use of clinical dehydrating agents.

关 键 词：闪光视觉诱发电位 颅内感染 无创颅内压监测 

分 类 号：R651.1[医药卫生—外科学]