超声多模式评估脑出血患者颅内压增高的临床价值

目的 探讨超声多模式联合检查评估脑出血患者颅内压(ICP)增高的临床价值.方法 纳入2019年9月至2021年6月延边大学附属医院重症监护病房内因病情需要行腰椎穿刺术的脑出血患者17例,在腰椎穿刺术前行超声测量视神经鞘直径(ONSD)及经颅多普勒超声(TCD)检查.根据脑脊液压力结果(大于200 mmH2 O定义为颅内...

The clinical value of Multi-mode ultrasound in evaluating cerebral hemorrhage with intracranial pressure

Objective To explore The clinical value of Multi-mode ultrasound in evaluating cerebral hemorrhage with intracranial pressure(ICP).Methods A total of 17 patients with cerebral hemorrhage who received lumbar puncture according to their medical necessity in the ICU of the Affiliated Hospital of Yanbian University from September 2019 to June 2021 were enrolled.The diameter of optic nerve sheath(ONSD)and transcranial Doppler ultrasound(TCD)were performed before lumbar puncture.The patients were divided into elevated intracranial pressure group(9 cases)and normal intracranial pressure group(8 cases),according to the results of lumbar puncture pressure(more than 200 mmH₂O was defined as elevated intracranial pressure,and 80~200 mmH₂O was defined as normal intracranial pressure).The Systolic blood pressure,diastolic blood pressure,partial pressure of carbon dioxide,GCS,ONSD and TCD parameters(such as peak systolic velocity,end diastolic velocity,mean blood flow velocity and pulse index of bilateral middle cerebral artery)were compared between the two groups,and the correlation between ICP and ONSD,pulse index(PI)was analyzed.Results(1)The systolic blood pressure,diastolic blood pressure,partial pressure of carbon dioxide(P_CO2)and GCS scores between the two groups were not significantly different(all P>0.05);(2)The ONSD was significantly higher in the elevated intracranial pressure group(5.15±0.24)mm vs.(3.97±0.22)mm,t=10.69,P<0.001)];(3)The systolic peak flow velocity(PSV),end diastolic flow velocity(EDV)and mean flow velocity(MV)between the two groups were not significantly different(all P>0.05),while the PI was significantly higher in the elevated intracranial pressure groupRight(1.20±0.19)vs.(0.95±0.12),t=3.148,P=0.007);Left(1.20±0.17)vs.(0.92±0.10),t=3.893,P=0.001)].(4)ICP was significantly associated with PI(r=0.52,P<0.02)and ONSD(r=0.64,P<0.01).Conclusion Combine with Ultrasonographic ONSD measurement and TCD can effectively assess intracranial hypertension in patients with intracerebral hemorrhage.