36例急性脑出血患者无创脑水肿动态监护仪的临床观察.docVIP

36例急性脑出血患者无创脑水肿动态监护仪的临床观察 　　作者：戴方瑜 唐维国 韩钊 刘建荣 作者单位：32500 温州医学院第一附属医院脑血管科[(戴方瑜现为温州医学院2005级在职研究生)、通讯作者：韩钊]316000 浙江省舟山市人民医院神经内科(唐维国)200025 上海交通大学医学院附属瑞金医院神经内科(刘建荣) 　　【摘要】目的 研究急性脑出血患者脑水肿动态变化。 方法 36例发病24h内急性脑出血患者按血肿量的大小分三个组,所有患者均于病程第1、3、5、7天采用无创脑水肿动态监护仪动态检测综合扰动系数。结果 病程第1天三组均表现为出血侧综合扰动系数低于健侧。三组3d时患侧扰动系数升高,超过健侧,达到高峰,持续到7d;三组3d时患侧高于健侧,5d时两侧接近,7d时又下降;病程第3、5、7天时三组相比有显著性差异。三组病程第3、5天时患侧与同组健侧对比有极显著性差异(P0.01)，及第1、7天患侧与同组健侧对比有显著性差异(P0.05)。 结论 急性脑卒中患者综合扰动系数呈现先低后高的动态变化,反映了水肿形成过程及脑水肿发生的时间(包括脑水肿高峰间)，及时反映脑内病灶周围组织水肿的动态变化,对急性脑出血患者的治疗有一定的指导意义。 　　【关键词】 脑出血 无创脑水肿动态监护仪 综合扰动系数 　　【Abstract】Objective To observe the change of comprehensive agitating coefficient in the intracerebral hemorrhage(ICH) patients using cerebral edema monitoring by non-invasive dynamical method ,who have accepted normalization therapy and ordinary therapy and to find out dynamical change on cerebral edema in patients with ICH, and to evaluate the specificity and sensitivity of non-invasive dynamical brain edema monitor in ICH treatment. Method thirty six patients with hypertensive ICH were divided into 3 groups by the hematoma(everyone was hospitalization in 24 hours after onset).The change of comprehensive agitating coefficient in the 36 patients was detected by non-invasive and dynamical brain edema monitor on day 1,3,5 and 7 from ICH onset. Result The comprehensive agitating coefficient in focus side was lower than the unaffected side in all groups at the first day. In each group the comprehensive agitating coefficient in focus side which reached its peak on the third day and continued for more than 7 days rose and become higher than the unaffected side. In each group the coefficient in the focus side was higher than the unaffected side on the third day, and then became approximately equal on day 5 and basically normal on day 7. The comprehensive agitating coefficients were not significant in both groups on day 3,5, 7. However, the coefficients in focus side were significantly different to unaffected si