经颅多普勒预测颅脑损伤后颅内高压综合征的价值

目的 应用经颅多普勒检测大脑中动脉(MCA)血流动力学参数,探讨其预测颅脑损伤后颅内高压综合征(ICH)的价值.方法 前瞻性选择颅脑外伤患者122例,均接受经颅多普勒(TCD)监测,每天1次,最长7 d,若患者出现失代偿表现则停止检测.根据患者在检测期内是否出现ICH分为ICH组35例和非ICH组87例.记录MCA的收...

Value of transcranial Doppler in predicting intracranial hypertension after craniocerebral injury

Objective To explore the value of transcranial Doppler(TCD)hemodynamic parameters in predicting intracranial hypertension(ICH)after craniocerebral injury.Methods A total of 122 patients with craniocerebral injury were prospectively enrolled and received TCD monitoring once a day for up to 7 d.The test would be stopped if the patients showed decompensation.According to the presence of ICH,patients were divided into ICH group(n=35)and non-ICH group(n=87).The peak systolic velocity(Vs),end diastolic velocity(Vd),mean velocity(Vm),pulsatility index(PI),and resistance index(RI)of middle cerebral artery(MCA)were recorded.The maximum and mean values of each parameterΔVsMax andΔVMean,ΔVdMax andΔVdMean,△VmMax and△VmMean,ΔRIMean andΔRIMax,ΔPIMean andΔPIMax were calculated and compared.The trend of MCA hemodynamic parameters over time was analyzed.COX regression analysis was used to screen independent predictors for the risk of ICH,and the ROC curve was drawn to analyze the diagnostic efficacy in identifying ICH.Results The MCA hemodynamic parameters(Vs,Vm,and Vd)of patients in the non-ICH group showed a downward trend during the monitoring time,while RI and PI showed an upward trend.Compared with the non-ICH group,theΔPIMax value in the ICH group was increased(P=0.014).COX regression analysis indicated thatΔPIMax was an independent predictor of ICH(HR=1.710,P=0.027).ROC curve analysis indicated thatΔPIMax was a good indicator for identifying ICH(AUC=0.904),cut-off value was 0.148,the sensitivity and specificity were 80.00%and 90.80%,respectively.ConclusionΔPIMax of MCA can accurately identify ICH,and is hope to be used as a new indicator to predict ICH.