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目的确定闪光视觉诱发电位无创颅内压检测临床正常参考值范围,并与有创颅内压检测比较测量结果的等效性,评价其指导临床治疗的应用价值。方法对96例健康人和80颅内压增高的脑卒中患者应用无创颅内压检测,并对15例脑卒中患者行脑室穿刺引流术,比较应用甘露醇治疗前和治疗后30min,60min,120min,180min,240min有创颅内压和无创颅内压变化。结果 96例健康成人无创颅内压平均值为134.6±48.7mmH20,95%可信区间范围为74.8~193.6 mmH20。颅内压增高脑卒中患者无创颅内压平均值为245.7±61.8mmH20,与健康成人检测结果相比,有统计学差异性(P<0.05)。15例行脑室穿刺引流术的脑出血患者应用甘露醇125ml治疗前和治疗后无创颅内压和有创颅内压变化趋势一致,二种测量方法测量结果经过等效检验显示等效(P<0.01)。结论闪光视觉诱发电位无创颅内压检测与有创颅内压检测结果无明显差别,具有较好的临床应用价值。
Objective To determine the range of clinical normal reference value of noninvasive intracranial pressure testing of flash visual evoked potentials and to compare the equivalence of measured results with invasive intracranial pressure test to evaluate its clinical value. Methods Noninvasive intracranial pressure was measured in 96 healthy subjects and 80 stroke patients with cerebral infarction. Ventricular puncture drainage was performed in 15 stroke patients. Before and after treatment with mannitol, 30 min, 60 min, 120 min , 180min, 240min invasive intracranial pressure and noninvasive intracranial pressure changes. Results 96 cases of healthy adults with noninvasive intracranial pressure average of 134.6 ± 48.7mmH20, 95% confidence interval ranged from 74.8 to 193.6 mmH20. The mean value of non-invasive intracranial pressure was 245.7 ± 61.8mmH20 in stroke patients with increased intracranial pressure, which was significantly higher than that in healthy adults (P <0.05). Fifteen patients with intracerebral hemorrhage undergoing ventricular puncture and drainage were consistent with the trend of noninvasive intracranial pressure and intracranial pressure before and after mannitol 125ml treatment. The results of the two measurement methods showed equivalent after the equivalent test (P < 0.01). Conclusion There is no significant difference between the detection results of intracranial pressure with flash visual evoked potentials and invasive intracranial pressure, which has a good clinical value.