应用闪光视觉诱发电位监测两侧颅内压梯度的临床意义

Clinical significance of application in flash visual evoked potentials for monitor both sides of intracranial pressure gradient

目的探讨应用闪光视觉诱发电位(FVEP)无创颅内压监测颅脑损伤患者两侧颅内压梯度的变化及意义。方法选取颅脑损伤患者50例(观察组),对照组30例,入院时、以后每天分别监测左右通道诱发电位,观察N2波潜伏期所对应的颅内压值,计算出颅内压差值大小与病情发展趋势的关系。结果研究组两侧压力差大于对照组,血肿增大的23例,其两侧压力差也增高。血肿清除后和保守治疗血肿缩小,其压力差也减少。结论 FVEP无创颅内压监测是简单有效的监护技术,可以作为观察颅脑损伤患者病情的工具,能较准确的反映颅内压和颅内压差,及早发现脑疝前驱期,对早期治疗提供帮助。

Objective To summarize the significance of how to apply noninvasive intracranial pressure with flash visual e- voked potentials in the inspection of traumatic brain injured patients＇ both sides of intracranial pressure gradient chan- ges. Methods Fifty traumatic brain injured patients and 30 comparison groups were selected for everyday monitoring left and right channels evoked potentials, the related intracranial pressure to the wave N2 latencies was observed, and then the relation- ship between intracranial pressure and the tendency of state of illness was calculated. Results The results illustrated the pressure differences in both sides were more than the comparison groups＇, followed 23 cases of hematoma accretion as well as rises in both sides＇ pressure differences. After purge the hematoma, it showed that the cured hematoma had been reduced with their pressure differences declined. Conclusion The inspection of intracranial pressure with FVEP is an simple and efficient method for monitoring. It can also be used as a tool for observation of different state of the traumatic brain injury. Moreover, this method is able to accurately reflect the situation of intracranial pressure and difference in intraeranial pressure, which would detect the prophase of encephaIocele in time and early diagnosis could be took action.