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无创性脑电阻抗测定在脑出血患者脑水肿监测中的应用
  • ISSN号:1006-7876
  • 期刊名称:《中华神经科杂志》
  • 时间:0
  • 分类:R473.5[医药卫生—护理学;医药卫生—临床医学]
  • 作者机构:[1]首都医科大学北京宣武医院神经内科,100053, [2]首都医科大学北京宣武医院神经外科,100053, [3]重庆医科大学附属第二医院神经内科, [4]重庆医科大学附属第二医院神经内科
  • 相关基金:国家自然科学基金重点项目资助(50337020)
中文摘要:

目的 应用无创性脑电阻抗测定探讨急性脑出血患者脑水肿的变化规律及意义。方法 分别检测200名健康志愿者和78例脑出血患者的脑电阻抗扰动系数及其动态变化,通过多媒体图像分析系统计算头颅CT上血肿和血肿周围水肿的体积,并进行相关分析。结果 ①健康志愿者左、右大脑半球扰动系数分别为(7.98±0.95)和(8.02±0.71),基本对称(P〉0.05)。性别、年龄及3~6h连续检测前后对其无明显影响(P〉0.05)。②脑出血患者的总体检测阳性率为73.1%。血肿位于基底节区时阳性率最高(83.3%),病灶体积大于20ml者阳性率(80.0%~88.9%)明显高于体积小于20ml者(48.1%)。③脑出血患者血肿侧扰动系数由低于血肿对侧至逐渐升高并超过血肿对侧,这个“交叉”时间平均为起病后(19.67±11.52)h,在该时间点后血肿周围水肿体积较前明显增大(P〈0.05),同时扰动系数亦明显升高(P〈0.01)。④起病24h内的血肿侧扰动系数变化与血肿体积及血肿周围组织水肿体积无相关关系(P〉0.05);而病后3d的血肿侧扰动系数变化与血肿周围组织水肿体积具有显著正相关关系(r=0.5977,P〈0.01)。结论 脑电阻抗测定可较敏感地反映脑出血患者脑水肿的变化,扰动系数越高,则提示脑水肿越重。病灶位于基底节区时检测阳性率最高。该方法为临床上进行动态、床旁连续无创性脑水肿监测提供了新的有意义的手段。

英文摘要:

Objective To explore the change of brain edema in patients with intracerebral hemorrhage (ICH) by noninvasive cerebral electrical impedance (CEI) measurement. Methods An invariable secure current at a frequency 50 kHz and a intensity of 0, 1 mA was given into a person' s brain, and the CEI of the two hemispheres was converted into perturbative index (PI). PI of 200 healthy volunteers and 78 patients with ICH was measured by noninvasive Brain-Edema Monitor. The results of PI were compared with the volumes of hematoma and surrounding edema, which calculated by image analyzing system according to CT scan. Results ①In the normal group, PI in the left and right hemisphere was respectively 7.98 ± 0.95 and 8. 02 ± 0.71, and there was no significant difference between the either sides ( P 〉 0. 05 ). Age, sex and different measuring times did not obviously affect the PI values ( P 〉 0. 05 ). ②The total positive ratio of PI in ICH was 73.1%. PI was the most sensitive when the position located in the basal ganglia (83.3%)or the volumes of lesions were more than 20 ml (80.0%-88.9%), but was low when the volumes less than 20 ml or the position near the midline. ③In the patients with ICH, PI of the hematoma side initially was lower and finally higher than contralateral one. The average transitional time was ( 19. 67 ± 11.52) h. The ipsilateral PI after the transitional time was much higher than that before the transitional time in the same patients( P 〈 0. 01 ). The volumes of peri-hematoma edema were also significantly larger after the transitional time than before( P 〈 0. 05 ). ④There was a positive correlation between the ipsilateral PI and the volume of peri-hematoma edema in the patients 3 days after onset ( r = 0. 5977, P 〈 0. 01 ). But there was no such significant correlation within 24 h. Conclusions CEI may be a sensitive parameter for noninvasive monitoring the change of brain edema in patients with ICH. The higher the PI, the more severe the edema ca

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期刊信息
  • 《中华神经科杂志》
  • 北大核心期刊(2011版)
  • 主管单位:中国科协
  • 主办单位:中华医学会
  • 主编:
  • 地址:北京市东四西大街42号
  • 邮编:100710
  • 邮箱:office@cma.org.cn
  • 电话:010-85158210
  • 国际标准刊号:ISSN:1006-7876
  • 国内统一刊号:ISSN:11-3694/R
  • 邮发代号:82-703
  • 获奖情况:
  • 1996年中国科协第二届优秀期刊二等奖,中华医学会85周年优秀期刊二等奖,2002年中国科协第三届优秀科技期刊二等奖
  • 国内外数据库收录:
  • 美国化学文摘(网络版),荷兰文摘与引文数据库,荷兰医学文摘,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版),中国北大核心期刊(2000版)
  • 被引量:61988