超声测量视神经鞘直径的围术期应用进展  

Progress in perioperative application of ultrasonic measurement of optic nve sheath diameter

作　　者：徐文梅 殷文勤 杨万李 李江(综述) 林菁艳(审校)[1] XU Wenmei;YIN Wenqin;YANG Wanli;LI Jiang;LIN Jingyan(Department of Anesthesiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院麻醉科,四川南充637000

出　　处：《检验医学与临床》2024年第S02期180-183,共4页Laboratory Medicine and Clinic

摘　　要：随着外科技术的进步,特别是腹腔镜和机器人辅助手术的发展,术中应用二氧化碳气腹和多样的体位对患者的病理生理产生了更为复杂的影响。尤其值得注意的是,围手术期颅内压的变化可能对脑部血流灌注和氧合产生重要影响。因此,在手术过程中对颅内压进行有效监测显得尤为关键。目前,尽管脑室内压力测量等侵入式方法被视为颅内压监测的金标准,但其伴随的感染和出血风险限制了其广泛应用。近年来,以超声测量视神经鞘直径为代表的无创颅内压监测方法已得到广泛认可。众多研究已经证实了视神经鞘直径与颅内压之间存在线性关系。本文综合分析了人工气腹、体位变化、麻醉药物对视神经鞘直径的影响及其潜在机制,旨在为颅内压监测提供更全面的理论基础和实践指导。With the advancement of surgical technology,especially the development of laparoscopy and robot-assisted surgery,the use of carbon dioxide pneumoperitoneum and various postuses have more complex effects on the pathophysiology of patients.It is particularly noteworthy that perioperative intracranial pressure changes may have important effects on cerebral blood perfusion and oxygenation.Therefore,effective monitoring of intracranial pressure during operation is critical.Currently,although invasive methods such as intraventricular pressure measurement are considered the gold standard for intracranial pressure monitoring,their associated risks of infection and bleeding limit their widespread application.In recent years,the noninvasive intracranial pressure monitoring method represented by ultrasonic measurement of optic nerve sheath diameter has been widely recognized.Many studies have confirmed that there is a linear relationship between optic nerve sheath diameter and intracranial pressure.In this paper,the effects of artificial pneumoperitoneum,position change,anesthetic drugs on optic nerve sheath diameter and their potential mechanisms were comprehensively analyzed,aiming to provide a more comprehensive theoretical basis and practical guidance for intracranial pressure monitoring.

关 键 词：视神经鞘直径 超声 围术期 颅内压 

分 类 号：R614[医药卫生—麻醉学]