超声测量视神经鞘直径联合闪光视觉诱发电位监测颅脑损伤患者颅内压的临床价值  

Clinical value of optic nerve sheath diameter measured by ultrasound combined with flash visual evoked potential in monitoring intracranial pressure in patients with craniocerebral injury

作　　者：贾松 吴萍 何英超 牛苗苗 JIA Song;WU Ping;HE Yingchao;NIU Miaomiao(Department of Critical Care Medicine,the Second Central Hospital of Baoding,Hebei 072750,China)

机构地区：[1]河北省保定市第二中心医院重症医学科,072750 [2]河北省保定市第二中心医院新生儿科,072750

出　　处：《临床超声医学杂志》2023年第8期645-649,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 应用超声测量颅脑损伤患者视神经鞘直径(ONSD),探讨其联合闪光视觉诱发电位(FVEP)在颅脑损伤患者颅内压监测中的临床价值。方法 选取我院重症医学科收治的100例颅脑损伤患者,其中仅采用FVEP指导临床治疗者43例(对照组),FVEP联合ONSD指导临床治疗者57例(联合组),比较两组中颅内压升高者ONSD、颅内压的差异;分析ONSD、颅内压与颅内压升高的相关性。比较两组甘露醇使用时间及总量、急性肾损伤例数、住院费用、抗菌药物使用强度、住院时间、机械通气时间。结果 对照组与联合组中出现颅内压升高者分别为29例和22例,两组颅内压升高者颅内压比较差异无统计学意义;联合组和对照组中颅内压升高者ONSD均显著高于颅内压正常者,差异均有统计学意义(均P<0.05)。相关性分析显示,联合组ONSD、颅内压与颅内压升高均呈正相关(r=0.739、0.981,均P<0.05);且ONSD与颅内压呈正相关(r=0.752,P<0.05)。联合组甘露醇使用时间、住院时间、机械通气时间均短于对照组,甘露醇使用总量、急性肾损伤占比、住院费用、抗菌药物使用强度均少于对照组,差异均有统计学意义(均P<0.05)。结论 ONSD联合FVEP在颅脑损伤患者颅内压监测中具有重要意义,可用于指导临床用药。Objective To measure the optic nerve sheath diameter(ONSD)by ultrasound,and to investigate the clinical value of ONSD combined with flash visual evoked potential(FVEP)in monitoring intracranial pressure in patients with craniocerebral injury.MethodsA total of 100 patients with craniocerebral injury admitted to the department of critical care medicine in our hospital were selected.Among them,43 patients underwent FVEP-guided clinical treatment(control group),and 57 patients underwent FVEP combined with ONSD(combination group).ONSD and intracranial pressure of patients with increased intracranial pressure were compared between the two groups.The correlation of ONSD,intracranial pressure and increased intracranial pressure were analyzed.The usage time and total amount of mannitol,the proportion of patients with acute kidney injury,hospitalization cost,antibiotic usage intensity,hospital stay and mechanical ventilation time were compared between the two groups.ResultsThere were 29 patients and 22 patients with increased intracranial pressure in the control group and the combination group,respectively.There was no statistically significant difference in intracranial pressure in patients with increased intracranial pressure between the two groups.In both groups,patients with increased intracranial pressure had higher ONSD than that in patients with normal intracranial pressure,with statistically significant differences(both P<0.05).Correlation analysis showed that ONSD and intracranial pressure were positively correlated with increased intracranial pressure(r=0.739,0.981,both P<0.05),and ONSD was positively correlated with intracranial pressure(r=0.752,P<0.05).The usage time of mannitol,hospital stay and mechanical ventilation time in the combination group were significantly shorter than those in the control group,and the total amount of mannitol,proportion of patients with acute kidney injury,the hospitalization cost and antibiotic usage intensity were less than those in the control group,the differences were statisti

关 键 词：超声检查 视神经鞘直径 闪光视觉诱发电位 颅脑损伤 颅内压 

分 类 号：R445.1[医药卫生—影像医学与核医学]