无创脑水肿监护仪扰动系数对动脉瘤性蛛网膜下腔出血后病情检测能力的临床研究  

Clinical study on the serverity evaluation after subarachnoid hemorrhage by disturbance coefficient of non-invasive brain edema monitor

作　　者：潘鹏宇 李根 刘冬冬 孔睿 李侑埕 李佳朔 杨新宇 张文旭 朱泽超 田学实 闻亮 蒋为 朱廷准 冯华 梁国标 Pengyu Pan;Gen Li;Dongdong Liu;Rui Kong;Youcheng Li;Jiashuo Li;Xinyu Yang;Wenxu Zhang;Zechao Zhu;Xueshi Tian;Liang Wen;Wei Jiang;Tingzhun Zhu;Hua Feng;Guobiao Liang(Department of Neurosurgery,General Hospital Northern Theater Command,Shenyang 110016,China;Department of Neurosurgery,Southwest Hospital,Army Medical University,Chongqing 400038,China)

机构地区：[1]北部战区总医院神经外科,沈阳110016 [2]陆军军医大学西南医院神经外科,重庆400038

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第6期341-345,共5页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金面上项目(81971133、82071481、82301487);辽宁省“兴辽人才计划”(XLYC2002109);辽宁省重点研发计划(2019JH8/10300085、2021JH2/10300059);沈阳市科技计划(20-205-4-017)

摘　　要：目的评价无创脑水肿监护仪扰动系数(DC)与动脉瘤性蛛网膜下腔出血(SAH)患者病情严重程度的相关性。方法分析北部战区总医院神经外科自2020年9月至2021年6月收治的121例动脉瘤性SAH患者以及60例未破动脉瘤患者的临床资料。采用改良Fisher(mFisher)评分、GCS评分、Hent-Hess(H-H)分级评估患者的病情严重程度,采用无创脑水肿动态检测仪测定DC值,采用Spearman法分析DC值与mFisher评分、GCS评分、H-H分级的关系。结果动脉瘤性SAH患者DC值(169.38±2.24)高于未破动脉瘤患者(127.84±1.95),差异有统计学意义(P<0.01)。轻度、中度、重度意识障碍动脉瘤性SAH患者的DC值两两比较,差异均有统计学意义(P<0.01);轻型动脉瘤性SAH患者的DC值高于未破动脉瘤患者,差异有统计学意义(P<0.01)。H-HⅡ、Ⅲ、Ⅳ患者DC值两两比较,差异均有统计学意义(P<0.01);H-HⅠ~Ⅱ级动脉瘤性SAH患者的平均DC值高于未破动脉瘤患者,差异有统计学意义(P<0.01)。mFisherⅡ、Ⅲ、Ⅳ患者DC值两两比较,差异均有统计学意义(P<0.01);mFisherⅠ~Ⅱ级动脉瘤性SAH患者的平均DC值高于未破动脉瘤患者,差异有统计学意义(P<0.01)。相关性分析结果显示,DC值与GCS评分和H-H分级相关(r=-0.743、-0.713,P<0.001),与mFisher分级的相关性较弱(r=-0.512,P<0.001)。结论无创脑水肿监护仪DC值可反映SAH患者的病情严重程度,早期评估及监测可能为SAH患者有益。Objective To evaluate the correlation between the disturbance coefficient(DC)of a non-invasive brain edema monitor and the severity of patients with aneurysmal subarachnoid hemorrhage(SAH).Methods The clinical data of 121 patients with aneurysmal SAH and 60 patients with unruptured aneurysm in the Neurosurgery Department of General Hospital Northern Theater Command from September 2020 to June 2021 were analyzed.The severity of the patient&apos;s condition was evaluated using modified Fisher(mFisher)score,GCS score,and Hent-Hess(H-H)grading.The DC value was measured using a non-invasive brain edema dynamic detector,and the relationship between DC value and mFisher score,GCS score,and H-H grading was analyzed using the Spearman method.Results The DC value of patients with aneurysmal SAH(169.38±2.24)was higher than that of patients without ruptured aneurysm(127.84±1.95),and the difference was statistically significant(P<0.01).The DC values of aneurysmal SAH patients with mild,moderate,and severe consciousness disorders were compared pairwise,and the differences were statistically significant(P<0.01);The DC value of patients with mild aneurysmal SAH is higher than that of patients with unruptured aneurysm,and the difference was statistically significant(P<0.01).The DC values of H-HⅡ,Ⅲ,andⅣpatients were compared pairwise,and the differences were statistically significant(P<0.01);The average DC value of patients with H-H gradeⅠ-Ⅱaneurysmal SAH is higher than that of patients with unruptured aneurysm,and the difference was statistically significant(P<0.01).The DC values of mFisherⅡ,Ⅲ,andⅣpatients were compared pairwise,and the differences were statistically significant(P<0.01);The average DC value of mFisher gradeⅠ-Ⅱaneurysmal SAH patients was higher than that of patients with unruptured aneurysm,and the difference was statistically significant(P<0.01).The DC value was correlated with GCS score and H-H grading(r=-0.743,-0.713,P<0.001),and has a weak correlation with mFisher grading(r=-0.512,P<0.001

关 键 词：无创脑水肿监护仪 扰动系数 蛛网膜下腔出血 早期脑损伤 病情评估 

分 类 号：R743.35[医药卫生—神经病学与精神病学]