论文摘要
目的:颅内压(intracranial pressure, ICP)升高在中枢神经系统疾病患者中非常常见。有效地监测ICP有助于及时判断病情变化,对于指导治疗和判断预后等均有很重要的价值。目前准确测定ICP主要通过脑室造口引流术直接测定,但需要特殊装置。腰椎穿刺也常用来间接测定ICP。两者均属于有创性操作,并可能出现副作用,因此存在一定的局限性,有必要探索一种无创性ICP监测方法。眼球与颅腔相沟通,眼内静脉部分回流至颅内静脉丛,ICP升高时可导致眼内压(intraocular pressure,IOP)相应升高。与其他无创方法如经颅多普勒超声(TCD)、视网膜静脉压测定法等相比较,眼内压(intraocular pressure, IOP)测定具有操作方便,快捷,且费用低廉等优点。本研究我们通过同时测定多种中枢神经系统疾病住院患者的IOP和ICP,并分析两者之间的相关性,评价IOP测定用于无创ICP监测的可行性。方法:本研究测定了55例次(34例)中枢神经系统疾病患者的IOP与ICP,其基础疾病分别为病毒性脑膜炎、癫痫、结核性脑膜炎、感染性脑病、低颅压性头痛、蛛网膜下腔出血和脑梗塞,入选的患者均无青光眼及其他影响眼内压的疾病,采用双刻度Schiotz氏眼压计测量双眼IOP并计算每个患者双眼眼压的平均值,测眼压后立即采用腰椎穿刺法测定ICP,记录所有患者的IOP及ICP的数据后,对IOP和ICP的测量值采用直线相关回归分析,对回归系数进行显著性检验。结果:统计分析显示研究组患者左、右侧及双眼平均IOP均与ICP存在显著相关性(r=0.697、0.784和0.765,p值均<0.001)。结论:IOP与ICP具有相关性,通过测定IOP可反映ICP。
论文目录
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