脑外伤患者搏动指数与颅内压相关性研究

目的:探讨在脑外伤患者,经颅多普勒超声监测搏动指数是否能预测颅内压变化。方法:哥斯拉评分小于9分的脑外伤患者47名,入院后持续有创监测颅内压并计算脑灌注压,用经颅多普勒超声持续监测搏动指数,共监测5d。分别统计所有患者和哥斯拉预后评分3～5分患者中,搏动指数与颅内压的相关性及搏动指数与脑灌注压的相关性。结果:监测的5d中,颅内压和搏动指数进行性下降。在1、3、5d颅内压和搏动指数相关性显著(P<0.01)。在哥斯拉预后评分3～5分患者,颅内压和搏动指数相关性也十分显著(P<0.01)。脑灌注压和搏动指数只有在第5d时存在相关性。结论:脑外伤患者,搏动指数与颅内压相关性显著,在以后的临床工作中如果不能进行有创颅内压监测可以用无创的经颅多普勒超声监测搏动指数来预测颅内压变化。

Relationship between pulsatility index and intracranial pressure in patients with traumatic brain injury

Objective: To investigate relationship between pulsatility index(PI) measured by transcranial Doppler ultrasonography(TCD) and intracranial pressure(ICP) in patients with traumatic brain in jury(TBI).Methods:A total of 47 TBI patients with Glasgow Coma Scale(GCS) score < 9 were selected.Invasive intracranial monitoring and TCD ultrasonography for PI were performed for five days.ICP,cerebral perfusion pressure(CPP),PI values were recorded and calculated.The correlation and regression analysis between ICP,PI and CPP were analyzed in all selected cases and in patients with a Glasgow Outcome Score(GOS) of 3-5.Results:The decline in ICP and PI values was significant.The correlation between ICP and PI was strongly significant(P<0.01) on days 1,3 and 5.In patients with a GOS of 3-5,correlation of ICP and PI was also significantly(P<0.01).The only significant correlation between CPP and PI was observed on day 5.Conclusions: There is strong correlation between ICP and PI through the management period of TBI patients.It indicates that it is possible to use TCD ultrasonography-derived PI as a guide if invasive monitoring is not available.