超声测量视神经鞘直径预测颅内压增高的围手术期应用进展

Application progress of ultrasound measurement of optic nerve sheath diameter in predicting intracranial hypertension during perioperative period

视神经鞘(ONS)是颅内硬脑膜的直接延续,内有横梁式的蛛网膜下腔。当患者颅内压(ICP)升高时,脑脊液会经蛛网膜滤出使视神经鞘增宽,因此可以用视神经鞘直径(ONSD)预测ICP增高。目前,围手术期ICP监测手段较少,超声测量ONSD预测ICP的技术因具有无创、床旁、快速等优势在临床上被广泛应用,将该技术应用于围术期患者中可以提供术中ICP监测。本文就ICP监测现状、ONSD与ICP的关系、ONSD预测ICP增高的临界值及ONSD预测围术期ICP增高的应用前景作一综述,以期为围手术期应用超声测量ONSD预测ICP增高提供支持。

The optic nerve sheath(ONS)is the direct continuation of the intracranial dura mater with a transverse subarachnoid space.When intracranial pressure(ICP)of patients increases,cerebrospinal fluid will be filtered out through arachnoid membrane to widen the optic nerve sheath,so optic nerve sheath diameter(ONSD)can be used to predict ICP increase.At present,there are few monitoring methods for ICP during perioperative period.The technology of predicting ICP by ultrasonic ONSD measurement is widely used in clinic because of its advantages of noninvasive operation,bedside and rapidity.The application of this technology in perioperative patients can provide intraoperative ICP monitoring.This paper reviews the status of ICP monitoring,the relationship between ONSD and ICP,the critical value of ONSD in predicting ICP increase,and the application prospect of ONSD in predicting ICP increase during perioperative period,so as to provide support for the application of ultrasonographic ONSD in predicting ICP increase during perioperative period.