摘要
目的:评价意识评分、血生化指标与经颅多普勒超声测量值的相关性，探讨其评估开颅术后患者大脑中动脉状况的作用以指导临床决策。方法:本研究为观察性研究，收集2019年1月至2021年1月新疆医科大学第一附属医院神经重症监护室行开颅手术的82例患者作为研究对象，记录患者基本信息、入院评估[包括格拉斯哥昏迷评分（GCS）和急性生理与慢性健康评分（APACHE Ⅱ）]、实验室检查指标、动脉血气结果、经颅多普勒超声测量数值、基本生命体征，经单因素和多因素线性回归分析观察指标与搏动指数（PI）和阻力指数（RI）的相关性。结果:GCS（回归系数=0.009，P=0.038）、APACHE Ⅱ（回归系数=0.009，P＜0.001）、PI（回归系数=0.070，P＜0.001）3个影响因素与RI呈线性相关性。pH值（回归系数=-5.328，P=0.007）、RI（回归系数=6.630，P＜0.001）2个影响因素与PI呈线性相关性。结论:临床中可以试图通过GCS、APACHE Ⅱ和pH值间接对大脑中动脉血管弹性、阻力及血流情况进行评估，以进一步为临床决策提供指导。
Abstract
Objective:To evaluate the correlation of consciousness score, blood biochemical indicators, and transcranial Doppler ultrasound measurements, and to explore the role of assessing the middle cerebral artery status in patients after the craniotomy to guide clinical decision-making.Methods:82 patients who underwent craniotomy in the neurological intensive care unit of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2021, were retrospectively collected. The demographic information, admission assessment [including Glasgow Coma Score (GCS) and Acute Physiological and Chronic Health Evaluation (APACHE Ⅱ)], laboratory test indexes, arterial blood gas results, transcranial Doppler ultrasound measurement values, primary vital signs, and the correlation between the observed indexes and the pulsatility index (PI) and resistance index (RI) was analyzed by univariate and multivariate linear regression.Results:GCS (regression coefficient=0.009, P=0.038), APACHE Ⅱ (regression coefficient=0.009, P＜0.001), PI (regression coefficient=0.070, P＜0.001) were linear correlated with RI. The pH value (regression coefficient=-5.328, P=0.007) and RI (regression coefficient=6.630, P＜0.001) were linearly correlated with PI.Conclusion:Indirect assessment of middle cerebral artery vascular elasticity, resistance, and blood flow by GCS, APACHE Ⅱ, and pH can be attempted in the clinic to guide clinical decision-making further.
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