不同时间测量视神经鞘直径评估心搏骤停患者神经功能预后的价值  

Prognostic value of measuring optic nerve sheath diameter at different times for assessment of neurological prognosis in cardiac arrest patients

作　　者：郑建 陶真 杨坤 林忠宇 陈势 ZHENG Jian;TAO Zhen;YANG Kun;LIN Zhongyu;CHEN Shi(Department of Critical Medicine,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中西医结合医院重症医学科,浙江温州325000

出　　处：《中国现代医生》2025年第5期45-48,共4页China Modern Doctor

基　　金：浙江省温州市基础性科研项目(Y20210815)。

摘　　要：目的探讨在心搏骤停(cardiac arrest,CA)患者自主循环恢复(return of spontaneous circulation,ROSC)后不同时间测量视神经鞘直径(optic nerve sheath diameter,ONSD)评估神经功能预后的价值。方法选取2021年3月至2024年6月温州市中西医结合医院CA复苏成功后转入ICU的48例患者为研究对象。超声测量患者ROSC后初始、12~24h、第2天、第3天的ONSD。根据治疗后3个月的脑功能评分(cerebral performance categories,CPC)将患者分为神经功能不良组(CPC 3~5分,n=24)和神经功能良好组(CPC 1~2分,n=24)。使用受试者操作特征曲线分析各时间ONSD测量值对CA患者神经功能预后的预测价值。结果两组患者12~24h、第2天、第3天ONSD的差异均有统计学意义(P<0.001),曲线下面积分别为0.785、0.837和0.841。结论在CA患者ROSC后12~24h、第2天、第3天超声测量ONSD对预测神经功能预后有较好的价值,且第2天测量ONSD可能是评估CA后患者神经功能预后的最佳时机。Objective To investigate the value of measuring optic nerve sheath diameter(ONSD)at different times after the return of spontaneous circulation(ROSC)in evaluating the neurological function prognosis of patients with cardiac arrest(CA).Methods A total of 48 patients who successfully resuscitated from CA and transferred to the ICU in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to June 2024 were selected as subjects.ONSD was measured initially,12 to 24h,day 2 and day 3 after ROSC.According to the brain function score of 3 months after treatment cerebral performance categories(CPC),the patients were divided into poor neurological group(CPC 3-5 points,n=24)and neurological good group(CPC 1-2 points,n=24).The predictive value of ONSD measurements at each time for neurological outcome in CA patients was analyzed using receiver operating characteristic curves.Results There were significant difference in ONSD from 12 to 24 h,days 2 and 3 between two groups(P<0.001),and the area under the curve were 0.785,0.837 and 0.841,respectively.Conclusion Measuring the ONSD by ultrasonography at 12-24 hours,day 2,and day 3 after ROSC in post-CA patients have good value in predicting neurologic prognosis.Measurement of ONSD on day 2 may be the optimal time to evaluate the neurological prognosis of patients after CA.

关 键 词：心搏骤停 视神经鞘直径 预后 超声检查 

分 类 号：R741.04[医药卫生—神经病学与精神病学]