基于电阻抗断层成像技术评估急性大面积脑梗死患者不同降颅压方案的疗效  

Efficacy of different intracranial pressure-lowering regimens in patients with acute large-area cerebral infarction based on electrical impedance tomography

作　　者：陶路航 杭景 陈昕 刘晓光 董理 胡爱鹏 李育平 于海龙 TAO Luhang;HANG Jing;CHEN Xin;LIU Xiaoguang;DONG Li;HU Aipeng;LI Yuping;YU Hailong(Department of Neurology,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225001;Department of Neurocritical Care Medicine,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225001;Department of Neurosurgery,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225001)

机构地区：[1]扬州大学附属苏北人民医院神经内科,江苏扬州225001 [2]扬州大学附属苏北人民医院神经重症医学科,江苏扬州225001 [3]扬州大学附属苏北人民医院神经外科,江苏扬州225001

出　　处：《实用临床医药杂志》2025年第8期35-39,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省基础研究计划自然科学基金项目(BK20221280);2022年江苏省扬州市级计划——社会发展项目(YZ2022097);江苏省卒中学会菁英人才培育项目(N-2023-15-23)。

摘　　要：目的基于电阻抗断层成像(EIT)技术评估急性大面积脑梗死患者不同降低颅内压方案的治疗效果。方法选取75例急性大面积脑梗死患者作为研究对象,随机分为研究组40例(使用甘露醇联合白蛋白降低颅内压)和对照组35例(单纯使用甘露醇降低颅内压),采用EIT技术连续监测患者48 h内的颅内压变化。收集2组患者的临床资料,观察并比较2组患者的24 h内颅内压变化率、48 h内颅内压变化率、ICU入住时间、住院时间、抗生素使用时间和出院时美国国立卫生研究院卒中量表(NIHSS)评分,并进行为期90 d的生存随访。结果2组患者24 h内颅内压变化率差异无统计学意义(P>0.05);研究组48 h内颅内压变化率高于对照组,差异有统计学意义(P<0.05)。研究组ICU入住时间、住院时间和抗生素使用时间均短于对照组,出院时NIHSS评分低于对照组,差异有统计学意义(P<0.05)。随访结果显示,研究组生存时间长于对照组,90 d累积生存率高于对照组,但差异无统计学意义(P>0.05);研究组改良Rankin量表评分低于对照组,差异有统计学意义(P<0.05)。结论相较于单纯使用甘露醇,早期使用甘露醇联合白蛋白可在48 h内有效降低急性大面积脑梗死患者的颅内压,缩短住院时间并改善神经功能。Objective To evaluate the therapeutic effects of different intracranial pressure lowering regimens in patients with acute large-area cerebral infarction based on electrical impedance tomography(EIT)technology.Methods A total of 75 patients with acute large-area cerebral infarction were selected as the study subjects and randomly divided into study group(n=40,using mannitol combined with albumin to decrease intracranial pressure)and control group(n=35,using mannitol alone to decrease intracranial pressure).EIT technology was used to continuously monitor the changes in intracranial pressure within 48 hours in the patients.Clinical data of the two groups were collected,and the 24-hour intracranial pressure change rate,48-hour intracranial pressure change rate,ICU stay duration,hospitalization duration,antibiotic use duration,and National Institutes of Health Stroke Scale(NIHSS)score at discharge were observed and compared between the two groups.A 90-day survival follow-up was also conducted.Results There was no statistically significant difference in the 24-hour intracranial pressure change rate between the two groups(P>0.05).The 48-hour intracranial pressure change rate in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The ICU stay duration,hospitalization duration,and antibiotic use duration in the study group were all shorter than those in the control group,and the NIHSS score at discharge in the study group was lower than that in the control group,with statistically significant differences(P<0.05).The follow-up results showed that the survival duration in the study group was longer than that in the control group,and the 90-day cumulative survival rate in the study group was higher than that in the control group,but the differences were not statistically significant(P>0.05).The modified Rankin Scale score in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with t

关 键 词：急性大面积脑梗死 电阻抗断层成像 颅内压 白蛋白 甘露醇 神经功能 住院时间 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.9[医药卫生—临床医学] R319