Influence of CCT changes on prognosis of patients with different intracranial pressure after de-compression for acute craniocerebral injury
郑长瑞1
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作者信息
1. 河南开封杞县人民医院(河南开封 475200)
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摘要
目的 探讨急性颅脑损伤减压术后不同程度颅内压时脑血流循环时间(Cerebral Circulation Time,CCT)的变化对患者预后的影响.方法 选取我院2019年1月至2022年1月收治的84例行急性颅脑损伤减压术患者作为研究对象.在有创颅内压(Traumatic Intracranial Pressure,iICP)增高时(＞20mmHg)和降低为正常时(≤20mmHg)分别进行超声造影检查,测量CCT水平,比较不同iICP时CCT的变化,分析iICP与CCT的相关性及其临床诊断价值.结果 当患者体内iICP增高和恢复正常时心率、呼吸、体温、格拉斯哥昏迷评分(Glasgow Coma Score,GCS)、平均动脉压(Mean Arterial Pressure,MAP)、二氧化碳分压(Partial Pressure of Carbon Dioxide,PCO2)等指标比较,差异无统计学意义(P＞0.05),同一患者病变侧CCT与iICP增高时较iICP正常时明显延长;iICP增高时,病变侧CTT(9.36±2.49)s,非病变侧CCT(9.02±3.17)s,差异无统计学意义(t=0.773,P=0.440).心率、呼吸、体温、MAP、PCO2与CCT无相关性(P＞0.05),GCS与CCT呈正相关(r=0.282,P＜0.05).经ROC曲线分析得出,CCT的灵敏度为69.0％,特异度为89.3％,面积为0.860,SE为0.029.结论 急性颅脑损伤减压术后,CCT可以反应出患者颅内压力情况,对探索颅内压监测是一个很有潜力指标.
Abstract
Objective To investigate the effect of cerebral circulation time(CCT)on the prognosis of patients with dif-ferent intracranial pressure after decompression for acute craniocerebral injury.Methods Eighty-four patients who under-went decompression for acute head injury from January 2019 to January 2022 in our hospital were selected.Contrast-en-hanced ultrasonography was performed when invasive intracranial pressure(iICP)increased(＞20mmHg)and decreased to normal(≤20mmHg)to measure CCT levels.The changes of CCT at different iICP were compared,and the correlation be-tween iICP and CCT and its clinical diagnostic value was analyzed.Results There was no significant difference in heart rate,respiration,body temperature,Glasgow Coma Score(GCS),mean arterial pressure(MAP),partial pressure of carbon dioxide(PCO2)and other indicators when iICP increased and returned to normal(P＞0.05).In the same patient,when CCT and iICP increased on the lesion side,they were significantly longer than those when iICP was normal;when ilCP increased,CTT was(9.36±2.49)s on the lesion side and(9.02±3.17)s on the non-lesion side,but no significant difference was found(t=0.773,P=0.440).Heart rate,respiration,body temperature,MAP,and PCO2 were not correlated with CCT(P＞0.05),and GCS was positively correlated with CCT(r=0.282,P=0.032).Through ROC curve analysis,the sensitivity of CCT was 69.0％,the specificity was 89.3％,the area was 0.860,and the SE was 0.029.Conclusion CCT can reflect the intracranial pressure of patients with acute craniocerebral injury after decompression.It is a potential index for exploring in-tracranial pressure monitoring.
维普
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