CAJ | 학술논문

目的研究蛛网膜下腔出血(SAH)患者早期有创颅内压监测(腰椎穿刺测压或脑室外引流测压)与无创颅内压监测[闪光视觉诱发电位(F-VEP)监测]的差异性和适用性,并探讨颅内压、GCS评分与脑状态监测仪获取的数字化脑电信号[脑状态指数(CSI)、肌电指数(EMG)]之间的相关性. 方法对深圳市人民医院神经外科自2011年3月至2011年12月收治的33例GCS评分3～12分SAH患者早期行腰椎穿刺测压或脑室外引流测压,同步进行F-VEP无创颅内压监测及脑功能状态监测,分析无创与有创颅内压监测值是否存在差异以及上述指标间的相关性. 结果 (1)患者有创颅内压监测(腰椎穿刺测压/脑室外引流测压)与无创监测结果比较差异均无统计学意义(t=-0.069,P=.946；t=-0.158,P=0.876).(2)患者颅内压与CSI呈负相关关系(r=-0.898,P=0.000),与EMG呈正相关关系(r=0.938,P=0.000); GCS评分与CSI存在正相关关系(r=0.472,P=0.011),与颅内压暂未发现相关关系(r=-0.047,P=0.814),与EMG不存在相关关系(r=-0.170,P=0.388).控制颅内压、GCS评分因素后偏相关分析发现CSI和EMG无相关关系(r=0.288,P=0.138). 结论 (1)SAH患者F-VEP监测颅内压与腰椎穿刺测压法或脑室外引流测压法监测具有相似效用.(2)CSI和EMG与颅内压具有良好相关性,表明病情变化与颅内压动态变化趋势相一致.
목적 연구주망막하강출혈(SAH)환자조기유창로내압감측(요추천자측압혹뇌실외인류측압)여무창로내압감측[섬광시각유발전위(F-VEP)감측]적차이성화괄용성,병탐토로내압、GCS평분여뇌상태감측의획취적수자화뇌전신호[뇌상태지수(CSI)、기전지수(EMG)]지간적상관성. 방법 대심수시인민의원신경외과자2011년3월지2011년12월수치적33례GCS평분3～12분SAH환자조기행요추천자측압혹뇌실외인류측압,동보진행F-VEP무창로내압감측급뇌공능상태감측,분석무창여유창로내압감측치시부존재차이이급상술지표간적상관성. 결과 (1)환자유창로내압감측(요추천자측압/뇌실외인류측압)여무창감측결과비교차이균무통계학의의(t=-0.069,P=.946；t=-0.158,P=0.876).(2)환자로내압여CSI정부상관관계(r=-0.898,P=0.000),여EMG정정상관관계(r=0.938,P=0.000); GCS평분여CSI존재정상관관계(r=0.472,P=0.011),여로내압잠미발현상관관계(r=-0.047,P=0.814),여EMG불존재상관관계(r=-0.170,P=0.388).공제로내압、GCS평분인소후편상관분석발현CSI화EMG무상관관계(r=0.288,P=0.138). 결론 (1)SAH환자F-VEP감측로내압여요추천자측압법혹뇌실외인류측압법감측구유상사효용.(2)CSI화EMG여로내압구유량호상관성,표명병정변화여로내압동태변화추세상일치.
Objective To analyze the differences and feasibility of non-invasive intracranial pressure monitoring and invasive intracranial pressure monitoring in patients with subarachnoid hemorrhage (SAH) at early stage,an explore the correlation of intracranial pressure and scores of Glasgow Coma Scale (GCS) with digital electroencephalogram data (cerebral state index [CSI],eleetromyographic [EMG]) obtained by cerebral state monitoring (CSM).Methods Synchronous line of 33 parents with SAH,having 3-12 GCS scores,was chosen in our study; early invasive intracranial pressure monitoring (lumbar puncture manometry/ventricular drainage manometry) and non-invasive intracranial pressure monitoring (flash visual evoked potential [F-VEP] monitoring),and brain function condition monitoring (CSI and EMG) were performed on these patients; the difference of non-invasive and invasive monitoring and the correlation of intracranial pressure with these indicators were analyzed.Results Non-invasive and invasive intracranial pressure monitoring results showed no significant difference in patients with SAH(t=-0.069,P=0.946; t=-0.158,P=0.876).The intracranial pressure was negatively correlated with CSI (r=-0.898,P=0.000) and positively correlated with EMG (r=0.938,P=0.000); GCS scores showed positive correlation with CSI (r=0.472,P=0.011) and showed no relation with intracranial pressure and EMG (r=-0.047,P=0.814; r=-0.170,P=0.388).In addition,after intracranial pressure being controlled and GCS scores being adjusted,partial correlation analysis indicated that CSI and EMG had no correlation (r=0.288,P=0.138).Conclusion Spontaneous F-VEP monitoring results have a high correlation with the results of lumbar puncture manometry and ventricular drainage manometry; intracranial pressure has correlation with CSI and EMG; dynamic intracranial pressure monitor trends are consistent with the changes of disease condition.