床旁超声实时动态测量视神经鞘直径在神经重症患者中的临床应用  

Clinical Application of Real-Time Dynamic Measurement of Optic Nerve Sheath Diameter by Bedside Ultrasound in Patients with Severe Neurological Conditions

作　　者：蒋潇潇 JIANG Xiaoxiao(Department of Neurology,Tanzhou People's Hospital of Zhongshan City,Zhongshan 528467,China)

机构地区：[1]广东省中山市坦洲人民医院神经内科,广东中山528467

出　　处：《中国伤残医学》2024年第18期44-48,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：中山市医学科研项目(2021A020240)。

摘　　要：目的:探讨床旁超声实时动态测量视神经鞘直径(ONSD)在神经重症患者中的临床应用效果。方法:选择2021年4月-2023年3月中山市坦洲医院收治的50例神经重症患者为研究组,选择同期就诊的50例非神经重症患者为对照组。测量两组ONSD检测值,分析研究组ICP检测值与ONSD检测值的相关性,将研究组按ICP检测情况分为ICP增高组与正常组,对比两组治疗前后的ICP与ONSD检测值、意识状态及预后情况,绘制受试者工作特征(ROC)曲线,分析ONSD的预测价值。结果:研究组ONSD检测值高于对照组,差异有统计学意义(P<0.05)。研究组ICP检测值与ONSD值呈正相关(r=0.386,P<0.05)。根据ICP检测情况分组,治疗后,ICP增高组ICP、ONSD检测值均低于治疗前,但高于ICP正常组,格拉斯哥预后量表分级情况均优于治疗前,但低于ICP正常组,差异均有统计学意义(P<0.05)。ONSD预测ICP值增高的曲线下面积为0.968,灵敏度为90.6%,特异度为88.90%,约登指数为0.795。结论:神经重症患者ONSD检测值异常增高,其与ICP检测值呈正相关,ICP增高的神经重症患者预后效果较差,ONSD检测值可准确预测患者发生ICP增高情况,有助于指导临床治疗。Objective:To investigate the clinical effect of real-time dynamic measurement of optic nerve sheath diameter(ONSD)by bedside ultrasound in patients with severe neurological conditions.Methods:50 patients with severe neurological conditions admitted to Tanzhou People’s Hospital of Zhongshan City from April 2021 to March 2023 were selected as the study group,and 50 patients with non-severe neurological conditions admitted during the same period were selected as the control group.ONSD detection values of the two groups were measured,the correlation between ICP detection values and ONSD detection values of the study group was analyzed,and the study group was divided into the increased ICP group and the normal group according to ICP detection conditions.ICP and ONSD detection values,consciousness status and prognosis of the two groups before and after treatment were compared,and receiver operating characteristic(ROC)curves were drawn.Analyze the predictive value of ONSD.Results:The ONSD detection value of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was a positive correlation between ICP and ONSD(r=0.386,P<0.05).According to the status of ICP detection,after treatment,the ICP and ONSD detection values in the increased ICP group were lower than before treatment,but higher than that in the normal ICP group,and the Glasgow prognostic Scale grading was better than before treatment,but lower than that in the normal ICP group,with statistical significance(P<0.05).ONSD predicted that the area under the curve of ICP increase was 0.968,the sensitivity was 90.6%,the specificity was 88.90%,and the Jorden index was 0.795.Conclusion:The abnormal increase of ONSD detection value in patients with severe neurological conditions is positively correlated with the detection value of ICP.The prognosis of patients with severe neurological conditions with increased ICP is poor.The detection value of ONSD can accurately predict the occurrence of increased ICP in p

关 键 词：神经重症 视神经鞘直径 床旁超声 

分 类 号：R742[医药卫生—神经病学与精神病学]