36例急性脑出血患者无创脑水肿动态监护仪的临床观察

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1、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崽者脑水肿动态变化。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-: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

2、过健侧，达到高峰,持续到7d;三组3d吋患侧高于健侧,5d吋两侧接近,7d时乂下降;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（PvO.Ol）,及第1、7天患侧与同组健侧对比有显著性差异（P<0.05）o结论急性脑卒屮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），及吋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]ObjectiveToobservethechangeof

3、comprehensiveagitatingcoefficientintheintracerebralhemorrhage（ICH）patientsusingcerebraledemamonitoringbynon-invasivedynamicalmethod,whohaveacceptednormalizationtherapyandordinarytherapyandtofindoutdynamicalchangeoncerebraledemainpatientswithICH,andtoevaluatethespecificityandsensitivityo

4、fnon-invasivedynamicalbrainedemamonitorinICHtreatment.MethodthirtysixpatientswithhypertensiveICHweredividedinto3groupsbythehematoma(everyonewashospitalizationin24hoursafteronset).Thechangeofcomprehensiveagitatingcoefficientinthe36patientswasdetectedbynon-invasiveanddynamicalbrainedemamo

5、nitoronday1,3,5and7fromICHonset.ResultThecomprehensiveagitatingcoefficientinfocussidewaslowerthantheunaffectedsideinallgroupsatthefirstday.Ineachgroupthecomprehensiveagitatingcoefficientinfocussidewhichreacheditspeakonthethirddayandcontinuedformorethan7daysroseandbecomehigherthantheunaf

6、fectedside.Ineachgroupthecoefficientinthefocussidewashigherthantheunaffectedsideonthethirdday,andthenbecameapproximatelyequalonday5andbasicallynormalonday7.Thecomprehensiveagitatingcoefficientswerenotsignificantinbothgroupsonday3,5,7・However,thecoefficientsinfocussideweresignificantlydi

7、fferenttounaffectedsideineachgrouponday3,5(p<0.01),andquitedifferentondayl,7(p<0.05).ConclusionsThecomprehensivedisturbancecoefficienttakesondynamicalchangesintheICHandreflectsthecourseofedemaformation.Cerebraledemamonitoringbynon-invasiveanddynamicalmethodcanevaluatethecourseo