CAJ | 학술논문

目的：探讨神经鞘直径（Optic Nerve Sheath Diameter，ONSD）超声监测在颅高压患者术后的临床应用。方法：选择2013年11月-2014年5月本院颅脑疾病患者26例为观察组，根据入院时GCS评分为重型颅脑损伤患者15例，大面积脑梗死6例，脑肿瘤5例，术后1、2、3 d根据病情变化动态用彩超经眼眶检查观察组眼球后3 mm处ONSD大小，每眼每次检查3次，计算ONSD平均值，同时观察生命体征和GCS评分变化，统计生存率。结果：术后平均ONSD<5 mm 17例，>5 mm 6例，>6 mm 6例；死亡7例，植物生存2例。结论：动态监测颅脑术后ONSD变化有助于正确判断颅脑术后患者的病情变化，指导及时复查CT或再次手术，可成为神经重症监护病房常规监测手段。
목적：탐토신경초직경（Optic Nerve Sheath Diameter，ONSD）초성감측재로고압환자술후적림상응용。방법：선택2013년11월-2014년5월본원로뇌질병환자26례위관찰조，근거입원시GCS평분위중형로뇌손상환자15례，대면적뇌경사6례，뇌종류5례，술후1、2、3 d근거병정변화동태용채초경안광검사관찰조안구후3 mm처ONSD대소，매안매차검사3차，계산ONSD평균치，동시관찰생명체정화GCS평분변화，통계생존솔。결과：술후평균ONSD<5 mm 17례，>5 mm 6례，>6 mm 6례；사망7례，식물생존2례。결론：동태감측로뇌술후ONSD변화유조우정학판단로뇌술후환자적병정변화，지도급시복사CT혹재차수술，가성위신경중증감호병방상규감측수단。
Objective:To assess the relationship between optic nerve sheath diameter (ONSD) measured on bedside ultrasound (US) and simultaneously measured intracranial pressure (ICP) in patients.To explore the the clinical application of ONSD in the intracranial hypertension patients after surgery.Method:Twenty-six brain disease patients were included in this study,contained 15 patients with heavy brain injured patients,6 large area cerebral infarction and 5 brain tumor.The Sonosite color Doppler US was used to measure ONSD on bedside postoperation in the first,second and third days.and monitoring vital signs and GCS score,survival rate.To statistically analyze all data.Result:The average postoperative ONSD <5 mm of the brain disease patients after surgery were 17 cases,>5 mm were 6 cases,>6 mm were 6 cases,the death were 7 cases,the plant survival were 2 cases.Conclusion:These data suggest that dynamic monitoring of ONSD changes after craniocerebral operation was helped to correctly judge patients after craniocerebral operation condition changes,Guidance and timely recheck CT or reoperation,can become a routine means of neurological Intensive Care Units.