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超声测量视神经鞘直径与眼球横径比值在颅内微创血肿穿刺引流中的应用

Application of ultrasonic measurement of the ratio of optic nerve sheath diameter to eyeball transverse diameter in patients with intracranial minimally invasive hematoma puncture and drainage

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【作者】 刘慧李月春郝喜娃吕琳梁磊张文思张翠琴张元张京芬

【Author】 LIU Hui;LI Yuechun;HAO Xiwa;LYU Lin;LIANG Lei;ZHANG Wensi;ZHANG Cuiqin;ZHANG Yuan;ZHANG Jingfen;Department of Neurology,Baotou Central Hospital;

【通讯作者】 张京芬;

【机构】 包头市中心医院神经内科内蒙古自治区神经系统疾病临床医学研究中心内蒙古赤峰市医院神经内科

【摘要】 目的 评价超声测量视神经鞘直径与眼球横径比值与颅内微创血肿穿刺引流患者血肿量变化的关系。方法 收集2020年10月至2022年4月就诊于内蒙古包头市中心医院的自发性脑出血且行脑血肿穿刺引流患者资料。在行血肿穿刺引流术前后及引流期间复查CT的同时使用超声测量视神经鞘直径(optic nerve sheath diameter,ONSD)和眼球横径(eyeball transverse diameter,ETD)。研究ONSD/ETD比值与颅内血肿量变化的关系。结果 57例脑出血并行脑血肿微创穿刺引流术患者入组,穿刺前后ONSD、ONSD/ETD比值的变化情况采用重复测量资料的方差分析,通过广义估计方程分析时间因素对于血肿量的影响,得到时间因素对血肿量间呈显著负相关关系(β<0)。通过广义估计方程分析时间因素和血肿量对ONSD,ONSD/ETD指标的影响,时间因素和血肿量对ONSD、ONSD/ETD指标均呈显著正相关关系,且时间因素与ONSD、ONSD/ETD呈显著负相关关系(β<0),血肿量与ONSD、ONSD/ETD呈显著正相关关系(β<0)。双眼测量的ONSD,ONSD/ETD比值,其中左侧ONSD(0.52±0.08)与右侧(0.53±0.09)无统计学差异(t=-0.41,P=0.68)。左侧ONSD/ETD比值(0.24±0.04)与右侧ONSD/ETD比值(0.24±0.04)无统计学差异(t=-0.19,P=0.85)。入院时出血侧ONSD(0.53±0.08)与未出血侧ONSD(0.52±0.09)相比无统计学差异(t=1.84,P=0.07)。入院时出血侧ONSD/ETD比值(0.24±0.04)与未出血侧ONSD/ETD比值(0.24±0.04)相比无统计学差异(t=1.42,P=0.16)。结论 ONSD/ETD比值可随颅内微创血肿穿刺引流患者血肿量变化呈现动态变化。

【Abstract】 Objective To evaluate whether the ratio of optic nerve sheath diameter to eyeball transverse diameter measured by ultrasound could be used as a method to evaluate the changes of intracranial pressure after intracranial minimally invasive hematoma puncture. Methods Patients with spontaneous intracerebral hemorrhage who underwent puncture and drainage of intracerebral hematoma in Baotou Central Hospital of Inner Mongolia from October 2020 to April 2022 were recruited. Patients who met the inclusion criteria and exclusion criteria were reexamined with CT before, after and during intracranial minimally invasive hematoma puncture and drainage. The optic nerve sheath diameter(ONSD) and eyeball transverse diameter(ETD) were measured by ultrasound. The variance analysis of repeated measurement data was used for the changes of ONSD and ONSD/ETD before and after puncture. The relationship between ONSD/ETD and the volume of intracranial hematoma were examined. Results Fifty-seven patients with cerebral hemorrhage who underwent minimally invasive puncture and drainage of cerebral hematoma were enrolled. Generalized estimation equations(GEE)showed that the indexes of hematoma volume, ONSD and ONSD/ETD were associated with time course and the hematoma volume was positively correlated with ONSD and ONSD/ETD. The left and right ONSD were 0.52±0.08 and 0.526±0.09,respectively and difference was not significant(t=-0.411, P=0.683). The left and right ONSD/ETD ratio were 0.24±0.04 and 0.24±0.04, respectively and difference was not significant(t=-0.19, P=0.85). There was no significant difference between ONSD on the bleeding side(0.53±0.08) and ONSD on the non-bleeding side(0.52±0.09) at admission(t=1.842,P=0.071). There was no significant difference between ONSD/ETD ratio of bleeding side(0.24±0.04) and that of non-bleeding side(0.24±0.04) at admission(t=1.420, P=0.161). Conclusion ONSD/ETD ratio could dynamically observe the change of intracranial pressure.

【基金】 内蒙古自治区神经系统疾病临床医学研究中心专项匹配资金
  • 【文献出处】 中国神经精神疾病杂志 ,Chinese Journal of Nervous and Mental Diseases , 编辑部邮箱 ,2022年12期
  • 【分类号】R651.1
  • 【下载频次】12
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