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1、无创动态监测脑卒中患者脑水肿的临床研究无创动态监测脑卒中患者脑水肿的临床研究?摘??要?目的:应用BORN-BE无创脑水肿动态监护仪观察脑卒中患者不同病程脑水肿变化情况,同时观察应用20%甘露醇125ml对脑卒中患者脑水肿的疗效。?方法:采用BOEN-BE无创脑水肿动态监护仪,通过观察病程1~10d双侧大脑半球脑阻抗扰动系数的变化,测定脑卒中患者脑水肿的变化情况,并与头颅TC检查显示的出血量及血肿周围低密度容积进行比较;通过连续监测脑卒中患者予以20%甘露醇125ml脱水治疗前后多时相扰动系数的变化,评价脱水效果。结
2、果:8中患者。①?脑出血患者入院1d时患侧扰动系数明显低于健侧P<脑出血患者病程0.05,7d5d、3d、及脑梗塞患者病程7d5d、3d、1d、均为患侧明显高于健侧P<0.05,3d时差异最明显,7d后脑卒中患者双侧扰动系数无明显差异P>0.05;所有患者病程第3d、5d、7d患侧扰动系数分别与病程1d时有显著差异P<0.05。②?脑出血患者入院1d时患侧扰动系数与出血量显著负相关r-0.599,?P病程0.023,3d、7d时患侧扰动系数与头颅TC所示血肿周围低密影容积显著正相关(r0.920,?P0.000;r0
3、.599,?P0.039)。③?8例脑卒中患者予以?20%甘露醇125ml给药脱水治疗,0.5h约后脑阻抗扰动系数开始降低,2~3h降低最为明显,5~6h接近用药前。?结论:①?BORN-BE无创脑水肿动态监护仪可较敏感、客观的反映脑卒中患者脑脑②?脑梗塞患者患侧扰动系数明显升高、内病灶周围水肿的动态变化。24h出血患者表现为患侧先降低,均于左右开始升高,3d左右达到高峰7d期,扰动系数的动态变化能反映脑卒中后脑水肿的后逐渐恢复正常,③?20%甘露醇变化。125ml一般能降低脑卒中患者的脑阻抗扰动系数,宜6h左右用药
4、1次。?关键词:I脑卒中?脑水肿?脑阻抗无创脑水肿动态监护仪??扰动系数例脑卒例,连续监测14例,脑出血18例,其中脑梗塞32共收集病例Non-invasiveandDynamicalMethodMonitoringCerebralEdemaforStrokePatientsinClinicAbstractObjective:?ToobservethechangesofbrainedemaindifferentcoursesofstrokepatientsbytheBORN-BEnon-invasionbrained
5、emamonitor,andtheeffectofrelievingbrainedemabyusing125mlmannitol?Methods:?Brainedemainthirty-twostrokepatientswasdetectedbyBORN-BEnon-invasivebrainedemamonitorbyobservingthechangesofimpedancevalueinbilateralcerebralhemispheresatdays1~10aftertheonsetofstrokeAndt
6、oevaluatetheeffectof125mlmannitolinstrokepatientsbycontinuouslydetectingthechangesofimpedancevalueinbilateralcerebralhemispheresbeforeandafterdehydrationResults:Thirty-twopatientswithstrokeincluding18ofcerebralinfarctionand14ofcerebralhemorrhagewereinvolvedinth
7、estudy,?8ofthemwerecontinuouslydetectedTheimpedancevalueintheaffectedsideofcerebralhemorrhagepatientsstaftertheonsetofICHwassignificantlylowerat1dayandsignificantlyhigheratrdthth3,5,7daythanthatintheunaffectedside(P0.05Theimpedancevalueinstrdthththeaffectedside
8、ofcerebralinfarctionpatientsat1,3,5,7daywassignificantlyhigherthanthatintheunaffectedside(P0.05)Thedifferencewasmostrdthsignificantat3dayTherewasnosignificantdifferenceafter
