摘要
目的:目前无创颅内压监测仪尚未在临床得到广泛和熟练应用,总结无创颅内压监测仪临床应用中的N2波形特点,为今后的工作提供指导意义。方法:①实验对象:选取2006-01/2007-01珠江医院神经外科住院颅脑损伤患者50例,分成3组,其中颅内血肿急诊手术组20例,颅内血肿保守治疗后加重再手术组10例,颅内血肿保守治疗组20例,以及正常对照组20例。均对本实验知情同意。②主要实验仪器:应用MICP-1A型无创颅内压监测仪(重庆名希公司),闪光眼罩,所产生的光源为蓝色氖光,闪光刺激频率1.0Hz,闪光脉冲宽度2ms,闪光次数70次(1次/s),枕部电极和额部电极。③实验评估:前两组分别监测手术前后颅内压闪光视觉诱发电位值,共3次,后两组在相应时间分别测定闪光视觉诱发电位值,每次监测颅内压后即刻腰穿测定颅内压进行对照。闪光视觉诱发电位颅内压监测时,15min内连续3遍测定闪光视觉诱发电位值并记录,取平均值,分析所记录240幅闪光视觉诱发电位的N2波,总结N2波特点,比较同一测试者随着颅内压的改变闪光视觉诱发电位值的变化情况。结果:闪光视觉诱发电位的N2波监测的颅内压结果和腰椎穿刺测定的颅内压结果等效(P>0.05),设定等效界值为0.098kPa(10mmH2O)。颅内血肿组闪光视觉诱发电位值均高于正常对照组(P<0.05)。在同一测试者,多次测量也可得出不同的波形,N2波的变化趋势稳定,N2波波幅与颅内压无关,N2波较宽,其波形的一个主要特点是前后均有较深的P波。颅内压越高N2波潜伏期越长。结论:闪光视觉诱发电位的值和腰穿测定颅内压结果基本接近,可以直接反应出颅内压的改变趋势,尽管N2波形变化较大,但是还是有规律可循,N2波的中点潜伏期可以作为测量颅内压的依据。
AIM： At present, the noninvasive measurement of intracranial pressure （ICP） is still not widely used in clinic. In this study, the feature of N2 waves dunng the noninvasive measurement of ICP was summarized with flash visual evoked potentials （FVEP）, so as to provide references for future work. METHODS： ①Fifty cases of craniocerebral injury were selected from Department of Neurosurgery, Zhujiang Hospital from January 2006 to January 2007 and divided into three groups： intracranial hematoma emergency operation group （n =20）, reoperation after conventional treatment group （n =10） and conventional treatment group （n =20）. Meanwhile, 20 normal individuals were selected as control. ②The instrument included MICP-1A noninvasive measurement of ICP （Chongqing Mingxi）, flash eyeshade with blue neon light; flash stimulation frequency was 1.0 Hz, with light impulse length （2 ms）, flash times for 70 times （once per second）, occiput electrode and frontal electrode. ③FVEP of the former two groups were detected before and after operation for 3 times, while the latter two groups were also detected at the corresponding time, and the ICP was measured by lumbar puncture immediately as control. FVFP were recorded for three times within 15minutes in every time, and the mean was calculated to analyze the N2 wave at 240 V. These wave＇s characters were summarized. The difference of the ICP measured by two ways. RFSULTS： ICP measured by N2 wave of FVFP and lumbar puncture was equivalent （P 〈 0.05）, and the equivalent margin was supposed to be 0.098 kPa （10 mm H20）. The FVFP of intracranial hematoma groups were higher than that in control group （P 〈 0.05）. In the same patient, N2 wave was unconstant in different measurements, and its amplitude was not related with ICP. In addition, N2 wave was wide with a deep P wave in the front and back of it. The higher the ICP, the longer the latency of N2 wave was. CONCLUSION： The ICP measured by FVFP and lumber puncture is nearly the same. They could reflect directly the change tendency of ICP. Although, N2 wave is mutable, there are still rules. The midpoint latency of N2 wave could act as the parameters for monitoring ICP.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第40期8095-8098,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
