隐球菌脑膜炎无创动态脑水肿监测分析

Results of non-invasive dynamic monitoring of encephaledema due to Cryptococcus meningitis

目的观察隐球菌脑膜炎患者脑水肿变化情况及脑水肿无创监测的灵敏性、稳定性。方法8例隐球菌脑膜炎患者纳入研究组；对照组10例均为排除颅内病变的周围神经病或肌肉疾病患者。采用BORN—BE无创脑水肿监护仪多次、动态监测每位患者双侧大脑半球的水肿指数，并观察脑水肿指数与腰穿测压有无一致性。甘露醇对脑水肿指数的影响。结果对照组患者的脑水肿指数多次监测结果重复性好，左右大脑半球对称。隐球菌脑膜炎组脑水肿指数为9．47±1．24。对照组为5．79±0．84，差异具有显著统计学意义；单次使用甘露醇125ml和250ml相比，脑水肿指数降低幅度无显著性差异，但使用250ml时作用可维持7～8h；对同一患者。脑水肿指数可粗略估计脑脊液压力水平。结论以BORN—BE无创脑水肿动态监护仪可客观监测隐球菌脑膜炎患者的脑水肿情况。

Objective To observe the changes of encephaledema in cryptococcal eningoencephalitis patients and test the sensitivity and stability of the non - invasive monitoring of brain edema. Methods Eight cryptococcal meningoencephalitis patientas and ten patients without intracranial disease were enrolled for observation. The changes of edema value in bilateral cerebral hemispheres in every patient, the correlation between hydrocephalus index and cerebrospinal fluid pressure, the impact of mannitol on hydrocephalus index were dynamically montored with BONE - BE non - invasive encephalaedema monitor. Results Reproductive results in monitoring of hydrocephalns index in control group were noticed in patients of control group, and there was no significant differences were observed in hydrocephalus index of bilateralis hemispheres. There no significant differences were noticed in reduction of hydrocephalus index in patients treated with a single dose of 12.5nd as compared with that treated with a single dose of 2.50nd mannitole with which the drug can maintain 7 to 8 hours. To the same patients the levels of cerebrospinal pressure can be used for roughly estimate hydrocephalus index. Conclusion BONE - BE non - invasive encephalaedema monitor can be use for sensitive and objective monitoring the changes of cerebral edema in cryptococcal eningoencephalitis patients.