闪光视觉诱发电位对颅内压水平的监测及其与血压、心率的关系

目的研究闪光视觉诱发电位（fVEP）无创监测颅内压的可行性及其临床应用价值。方法采用fVEP与硬膜外测压法检测197例脑外伤患者颅内压水平，有创检测均于fVEP检测完成后立即进行，同时记录患者血压及心率的变化。结果fVEP无创颅内压检测值与有创检测值一致性良好，配对t检验显示两者差异无统计学意义（P〉0．05）；心率与颅内压水平呈负相关，能较敏感地反映颅内压的波动，收缩压的敏感性次之，舒张压相对不易受颅内压变化的影响。结论fVEP可无创监测颅内压，有广泛的临床应用前景。

Clinical application of noninvasive monitoring of intracranial pressure by flash visual evoked potential

Objective To investigate the feasibility and value of using flash visual evoked potential (fVEP) as a noninvasive monitoring tool of intracranial pressure (ICP). Methods One hundred and ninety-seven patients with traumatic brain injury were monitored by using fVEP first and then extradural intracranial pressure monitor. The arterial blood pressure and cardiac rhythm were also measured at the same time. Results The ICP as measured by both fVEP and extradural intracranial pressure monitoring were positively correlated, with no statistically significant difference between them revealed (P>0.05, paired-samples t-test). Cardiac rhythm was shown to be negatively and significantly associated with the intracranial pressure. The systolic blood pressure was also sensitively correlated with the change of ICP. However, the diastolic blood pressure was less influenced by intracranial pressure variance. Conclusion fVEP could be a promising tool for monitoring ICP.