| Citation: |
ZHANG Jianbo, DING Junhong, ZHOU Litian, YANG Pinglai, JIAO Lei. Application value of ultrasonic measurement of optic nerve sheath diameter in patients with craniocerebral trauma[J]. Journal of Clinical Medicine in Practice, 2024, 28(13): 47-51. DOI: 10.7619/jcmp.20241141
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To investigate the application value of ultrasonic measurement of optic nerve sheath diameter (ONSD) in patients with craniocerebral trauma.
A total of 100 patients with craniocerebral trauma were selected as research subjects and randomly divided into control group and study group, with 50 patients in each group. Patients in the control group received invasive intracranial pressure (ICP) monitoring, while patients in the study group received invasive ICP monitoring combined with ultrasonic measurement of ONSD. Both groups were treated according to their actual conditions. The general information and treatment status of the two groups were observed, and the general information, ICP monitoring results, and ONSD ultrasonic measurement results of different ICP patients in the study group were compared. The correlation between ONSD and ICP in patients with craniocerebral trauma was analyzed, and the diagnostic efficacy of ONSD for ICP elevation in patients with craniocerebral trauma was also analyzed.
At 28 days after treatment, the mean arterial pressure of the study group was higher than that of the control group, while the heart rate and respiratory rate were lower than those of the control group(P < 0.05). The mechanical ventilation time and ICU stay of the study group were shorter than those of the control group, the amount of mannitol used was less than that of the control group, and the ICP and 28-day mortality rate after treatment were lower than those of the control group (P < 0.05). Patients with ICP≥22 mmHg had higher ICP than those with ICP < 22 mmHg, and ONSD before and after the use of mannitol in different positions was greater than that in the ICP < 22 mmHg group (P < 0.05). There was a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma (r=0.723, P < 0.001). The results of receiver operating characteristic curve analysis showed that the optimal cutoff value of ONSD for diagnosing ICP elevation was 5.25 mm, and the area under the curve was 0.879.
The combination of ICP monitoring and ultrasonic measurement of ONSD in the treatment of patients with craniocerebral trauma can effectively improve patients' vital signs, shorten the duration of mechanical ventilation and ICU stay, reduce the amount of mannitol used, and reduce the 28-day mortality rate. There is a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma, and ONSD has a high diagnostic efficacy for ICP elevation.
| [1] |
潘慧斌, 王志翔, 凌莉, 等. 神经危重症患者脑水肿急性治疗指南[J]. 中华急诊医学杂志, 2020, 29(9): 1162-1164.
|
| [2] |
GAO C, WANG H C, WANG T, et al. Platelet regulates neuroinflammation and restores blood-brain barrier integrity in a mouse model of traumatic brain injury[J]. J Neurochem, 2020, 154(2): 190-204. doi: 10.1111/jnc.14983
|
| [3] |
KERSCHER S R, SCHÖNI D, HURTH H, et al. The relation of optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in pediatric neurosurgery practice - Part Ⅰ: Correlations, age-dependency and cut-off values[J]. Childs Nerv Syst, 2020, 36(1): 99-106. doi: 10.1007/s00381-019-04266-1
|
| [4] |
孙曼, 周婷, 许铁, 等. 视神经鞘直径、神经元特异性烯醇化酶与颅脑外伤患者早期病情严重程度的相关性研究[J]. 中国急救复苏与灾害医学杂志, 2021, 16(11): 1252-1255. https://www.cnki.com.cn/Article/CJFDTOTAL-YTFS202111012.htm
|
| [5] |
MCLAUGHLIN D, ANDERSON L, GUO J H, et al. Serial optic nerve sheath diameter via radiographic imaging: correlation with ICP and outcomes[J]. Neurol Clin Pract, 2021, 11(5): e620-e626.
|
| [6] |
COOK N F. The Glasgow Coma scale: a European and global perspective on enhancing practice[J]. Crit Care Nurs Clin North Am, 2021, 33(1): 89-99. doi: 10.1016/j.cnc.2020.10.005
|
| [7] |
BENHUR A, SHARMA J, KARNA S T, et al. Analysis of dynamic changes in optic nerve sheath diameter (ONSD) with ultrasound in post-craniotomy patients: trends and correlation with computed tomography ONSD and Glasgow coma scale in post-operative period[J]. J Neurosci Rural Pract, 2022, 13(4): 676-683.
|
| [8] |
KERSCHER S R, SCHÖNI D, NEUNHOEFFER F, et al. The relation of optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in pediatric neurosurgery practice - Part Ⅱ: influence of wakefulness, method of ICP measurement, intra-individual ONSD-ICP correlation and changes after therapy[J]. Childs Nerv Syst, 2020, 36(1): 107-115. doi: 10.1007/s00381-019-04336-4
|
| [9] |
冼丽娜, 邓小彦, 梁娴, 等. 动态超声测量视神经鞘直径在中、重型颅脑损伤患者治疗中的临床价值[J]. 海南医学院学报, 2021, 27(13): 988-992. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY202113006.htm
|
| [10] |
高一铭, 姜美竹, 李草, 等. 神经外科降颅压药物的研究进展[J]. 中南药学, 2023, 21(12): 3267-3273. https://www.cnki.com.cn/Article/CJFDTOTAL-ZNYX202312022.htm
|
| [11] |
高超, 焦峻峰, 赵彦标. 甘露醇治疗急性脑卒中的药理机制及安全性研究进展[J]. 中国处方药, 2023, 21(2): 180-183. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCF202302054.htm
|
| [12] |
杨建华, 马艳君, 庄振燕. 超声测量西宁地区汉族、藏族重度颅脑损伤患者视神经鞘直径与颅内压增高变化的研究[J]. 重庆医学, 2021, 50(S01): 326-328.
|
| [13] |
于泽洋, 宋晓南, 李聪, 等. 超声测量视盘联合视神经鞘对重症高颅压患者的评估价值[J]. 中风与神经疾病杂志, 2021, 38(11): 976-979. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFSJ202111003.htm
|
| [14] |
FÉLIX H, SANTOS OLIVEIRA E. Non-invasive intracranial pressure monitoring and its applicability in spaceflight[J]. Aerosp Med Hum Perform, 2022, 93(6): 517-531. doi: 10.3357/AMHP.5922.2022
|
| [15] |
乔志飞, 刘春艳, 李树铁, 等. 超声参数ONSD对颅脑损伤患者颅内压增高的诊断价值[J]. 中国医疗设备, 2022, 37(6): 72-75. https://www.cnki.com.cn/Article/CJFDTOTAL-YLSX202206017.htm
|
| [16] |
VIJAY P, LAL B B, SOOD V, et al. Dynamic Optic Nerve Sheath Diameter (ONSD) guided management of raised intracranial pressure in pediatric acute liver failure[J]. Hepatol Int, 2021, 15(2): 502-509. doi: 10.1007/s12072-021-10139-0
|
| [17] |
柳成荫, 石祥恩, 王有全, 等. 超声监测视神经鞘直径在成年人颅内压增高患者诊治中的应用[J]. 中国医师进修杂志, 2022, 45(5): 403-406.
|
| [18] |
陶莹, 孙爱童. 超声测量视神经鞘直径在颅内压升高中的诊断价值[J]. 医学影像学杂志, 2022, 32(9): 1457-1460. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202209001.htm
|
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