无创动态监护仪在脑出血患者脑水肿动态变化监测中的研究

Study on the change of brain edema in intracerebral hemorrhage by non-invasive and dynamical method

目的：应用无创动态监护仪观察急性脑出血患者脑水肿动态变化。方法130例住院急性脑出血患者（均为发病24 h内入院），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天表现为出血侧综合扰动系数低于健侧，3 d时患侧扰动系数升高，超过健侧，达到高峰，5 d时两侧接近，7 d时两侧基本正常。病程第3天、5天时患侧与健侧差异有统计学意义（ P＜0．01），第1天、7天患侧与健侧差异有统计学意义（P＜0．05）。脑出血患者血压水平与综合扰动系数的变化无明显关系，除自身患侧与健侧相比综合扰动系数差异有统计学意义外，两组不同血压水平之间综合扰动系数差异无统计学意义。结论急性出血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，包括脑水肿高峰期，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。

Objective To observe the change of comprehensive agitating coefficient in the intracerebral hem -orrhage（ ICH） patients monitoring by non-invasive cerebral edema and dynamical method ,and to find out dynamical change of cerebral edema in patients with ICH ,and to evaluate the specificity and sensitivity of non-invasive dynami-cal brain edema monitor in ICH treatment .Methods The change of comprehensive agitating coefficient in 130 patients was detected by non-invasive dynamical brain edema monitor at day 1,3,5 and 7 from ICH onset.Results The comprehensive agitating coefficient in focus side was lower than the unaffected side in both groups at the first day .The coefficient in the focus side was higher than the unaffected side at the third day ,and then became approximately equal at day 5 and basically normal at day 7.The comprehensive agitating coefficients in focus side were significantly differ-ent to unaffected side at day 3,5（P〈0.01）,and quite different at day 1,7（P〈0.05）.Conclusion The compre-hensive disturbance coefficient takes on dynamical changes in the ICH and reflects the course of edema formation . Cerebral edema monitoring by non-invasive and dynamical method can evaluate the course of cerebral edema ,and has a guiding role to the therapy of the ICH .