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目的探讨对急性高血压性脑出血(HICH)患者用闪光视觉诱发电位(FVEP)进行无创颅内压(ICP)监测的临床价值。方法选取本院神经内科收治的110例急性HICH患者作为研究对象,根据患者治疗28 d的结局分为存活组87例和死亡组23例,分别对比2组患者入院后第12、24、48、72 h的ICP值,同时分析ICP值与患者的格拉斯哥昏迷评分(GCS)、急性生理与慢性健康评分(APACHEⅡ)、FVEP各波潜伏期的关系。结果存活组患者的出血量、血弹值、WBC、中线移位发生率均显著低于死亡组(P<0.05);在入院第12、24、48及72 h存活组患者的ICP值均显著低于死亡组患者(P<0.05);在入院第12 h存活组患者的GCS评分显著高于死亡组患者(P<0.05),APACHEⅡ评分、FVEP各波潜伏期(P2、N2、P3、N3)均显著低于死亡组患者(P<0.05);在入院第12 h HICH患者的ICP值与GCS评分呈显著负相关(r=-0.572,P<0.05),与APACHEⅡ评分、FVEP各波潜伏期(P2、N2、P3、N3)呈显著正相关(r=0.496,P<0.05)。结论通过监测HICH患者的ICP值能够密切反映患者的病情程度、预后情况,对于指导临床治疗具有一定的价值。
Objective To investigate the clinical value of noninvasive intracranial pressure (ICP) monitoring with flash visual evoked potentials (FVEP) in patients with acute hypertensive intracerebral hemorrhage (HICH). Methods A total of 110 patients with acute HICH admitted to our hospital were enrolled in this study. According to the outcome of 28 days of treatment, the patients were divided into survival group (n = 87) and death group (n = 23) 72 h ICP values were also analyzed. The relationship between ICP values and GCS, APACHE II and FVEP wave latency was also analyzed. Results The blood loss, blood bombing, WBC and midline shift in survival group were significantly lower than those in death group (P <0.05). The ICP values in survival group at 12, 24, 48 and 72 h after admission were significant (P <0.05). The GCS score of survival group at 12 h after admission was significantly higher than that of death group (P <0.05), APACHEⅡscore, latency of each wave of FVEP (P2, N2, P3, N3) (P <0.05). There was a significant negative correlation between ICP values and GCS scores at the 12th hour after hospital admission (r = -0.572, P <0.05), but not with the APACHEⅡ score and FVEP latency P2, N2, P3, N3) (r = 0.496, P <0.05). Conclusion The monitoring of HIC patients with ICP values can closely reflect the patient’s condition and prognosis, which is of certain value in guiding the clinical treatment.