超声参数ONSD对颅脑损伤患者颅内压增高的诊断价值

Diagnositc Value of Ultrasound Parameter ONSD for Increased Intracranial Pressure in Patients with Craniocerebral Injury

目的探究超声参数视神经鞘直径(Optic Nerve Sheath Diameter,ONSD)对颅脑损伤患者颅内压(Intracranial Pressure,ICP)增高的诊断价值。方法选取2019年4月至2020年4月我院收治的109例颅脑损伤患者作为研究对象,按照其ONSD值将其分为ICP正常组42例、ICP可疑升高组36例、ICP升高组31例。对颅脑损伤患者进行超声测量ONSD检查,以ONSD≥5.3 mm为阈值判断患者ICP是否升高。结果ICP升高组ONSD值高于ICP可疑升高组,具有统计学差异(P<0.05);三组患者眼球横径值对比显示差异无统计学意义(P>0.05);ONSD法诊断ICP升高的诊断价值较高,具有统计学差异(P<0.05);ICP升高组预后情况优于ICP可疑升高组,具有统计学差异(P<0.05)。ONSD预测ICP的ROC曲线下面积为0.897(0.821~0.936),灵敏度为86.59%,特异度为82.34%,准确度为91.25%。结论超声测量ONSD可实时、动态地预测颅脑损伤患者ICP增高的变化情况,敏感度、特异度较高,具有较高的预测价值。

Objective To study the diagnositc value of ultrasound parameter optic nerve sheath diameter(ONSD)for increased intracranial pressure(ICP)in patients with craniocerebral injury.Methods A total of 109 patients with craniocerebral injury admitted to our hospital from April 2019 to April 2020 were selected as the research objects.According to their ONSD values,they were divided into a normal ICP group of 42 cases,a suspected elevated ICP group of 36 cases,and an elevated ICP group of 31 cases.Ultrasound ONSD examination was performed on patients with craniocerebral injury,and ONSD≥5.3 mm was used as the threshold to determine whether the patient’s ICP was elevated.Results The ONSD value of the elevated ICP group was higher than that of the suspected elevated ICP group,with a statistical difference(P<0.05).The comparison of the eyeball transverse diameter values of the three groups showed no statistical difference(P>0.05).The diagnostic value of ONSD in the diagnosis of elevated ICP was higher,with statistical difference(P<0.05).The prognosis of the elevated ICP group was better than that of the suspected elevated ICP group,with a statistical difference(P<0.05).The area under the ROC curve of ONSD predicted ICP was 0.897(0.821-0.936),the sensitivity was 86.59%,the specificity was 82.34%,and the accuracy was 91.25%.Conclusion Ultrasound measurement of ONSD can predict the changes of ICP increase in patients with craniocerebral injury in real time and dynamically,with high sensitivity and specificity,and has high predictive value for patients with craniocerebral injury.