超声测量视神经鞘在新生儿颅内压增高的预测价值  

Predictive Value of Ultrasound Measurement of the Optic Nerve Sheath in Neonates with Increased Intracranial Pressure

作　　者：谢书 穆雨 王欣 周亚辉 马敬敬 周敬 曹海玮 XIE Shu;MU Yu;WANG Xin;ZHOU Ya-hui;MA Jing-jing;ZHOU Jing;CAO Hai-wei(Department of Ultrasound,Kaifeng Children’s Hospital,Kaifeng 475000,Henan Province,China)

机构地区：[1]开封市儿童医院超声科,河南开封475000

出　　处：《罕少疾病杂志》2024年第9期10-12,共3页Journal of Rare and Uncommon Diseases

基　　金：开封市科技攻关计划(2103060)。

摘　　要：目的分析超声测量视神经鞘(ONSD)预测新生儿颅内压(ICP)增高的效果。方法本研究主要选取2020年5月至2021年5月本院收治颅内压损伤的新生儿82例作为研究对象。所有患儿行ICP监测及ONSD测量。分析82例颅内压损伤的新生儿的ICP监测结果,且以ICP值分为ICP升高组(ICP≥20mm Hg)、ICP正常组(ICP<20mmHg)。比较两组一般资料及ONSD值。应用Spearman相关性分析探.讨ON.SD值与ICP之间的关联程度;绘制ROC曲线评估超声测量ONSD在预测新生儿ICP方面的预测效能。结果82例颅内压损伤的新生儿,平均ICP为(189.6±426)mmHg,其中ICP≥20mmHg32例(.ICP升高组),ICP<20mmHg50例(ICP正常组)。两组性别、年.龄、体重及.身长比较,差异无统计学意义(P>005)。ICP升高组ONSD值高于ICP正.常组(P<005)。经Spearman相关性分析,ONSD值与ICP呈正相关(r=0752,P<005)。但.两者未呈直.接线性增长,在本研究中,观察到最大ONSD值为652mm。以ICP.作为因.变量,ONSD作为自变量进行线.性回归统计分析时.,得.到的t值为10553,且.P<0001,两者之间存在显著统计相关性。回归方程可.以表示为Y=-5805+.1474X。超声测量ONSDAUC为0861,95%(CI)为0793-0928,最佳临界值为514mm;超声测量ONSD在预测新生儿ICP灵敏度为91量ONSD在新生儿ICP增高预测中具有一定的价值,其作为一种无创、便捷的监测手段,有助于临床医生及时发现ICP增高,为早期干预和治疗提供有力支持。Objective To analyse the predictive value of ultrasound measurement of the optic nerve sheath(ONSD)in neonates with increased intracranial pressure(ICP).Methods In this study,82 neonates with intracranial pressure injuries admitted to our hospital from May 2020 to May 2021 were selected for the study.All children underwent ICP monitoring and ONSD measurement.The results of ICP monitoring in 82 neonates with intracranial pressure injury were analysed and the ICP values were divided into an elevated ICP group(ICP≥20 mmHg)and a normal ICP group(ICP<20 mmHg).The general information and ONSD values of the two groups were compared.Spearman correlation analysis was applied to explore the degree of association between ONSD values and ICP;ROC curves were plotted to assess the predictive efficacy of ultrasonographic ONSD in predicting neonatal ICP.Results In 82 neonates with intracranial pressure injury,the mean ICP was(18.96±4.26)mmHg,of which 32 cases had ICP≥20 mmHg(elevated ICP group)and 50 cases had ICP<20 mmHg(normal ICP group).Comparison of gender,age,weight and length between the two groups showed no statistically significant difference(P>0.05).The ONSD value was higher in the group with elevated ICP than in the group with normal ICP(P<0.05).After Spearman correlation analysis,ONSD values were positively correlated with ICP(r=0.752,P<0.05).However,they did not show a direct linear increase,and in this study,the maximum ONSD value of 6.52 mm was observed.When linear regression statistics were analysed with ICP as the dependent variable and ONSD as the independent variable,a t-value of 10.553 was obtained with P<0.001,which indicates a statistically significant correlation between the two.The regression equation can be expressed as Y=-58.05+14.74X.The AUC of ultrasound measurement of ONSD was 0.861,with a 95%(CI)of 0.793-0.928,and the optimal threshold was 5.14 mm;the sensitivity of ultrasound measurement of ONSD in predicting ICP in neonates was 91.22%,and the specificity was 89.50%.Conclusion Ultrasound measur

关 键 词：超声 视神经鞘(ONSD) 新生儿 颅内压增高 预测 

分 类 号：R445.1[医药卫生—影像医学与核医学]