摘要
目的:通过与颅脑电脑断层扫描(CT)进行比较,探讨超声测量视神经鞘直径(ONSD)在伴有头痛的颅高压患者诊断中的运用价值。方法:前瞻性纳入120例因头痛而急诊就诊的患者。其中60例ONSD增加(≥5 mm)和60例ONSD正常(<5 mm)患者。先后进行ONSD测量及头颅CT检查,并将两者的检查结果进行比较。结果:①头颅CT正常范围内的患者,左、右ONSD中位数分别为4.4(3.6~5.6)vs.4.3(3.6~5.5)mm;头颅CT异常的患者,左、右ONSD中位数分别为5.3(5.1~6.5)vs.5.6(5.1~6.7)mm,双侧ONSD测量值均差异无统计学意义(P>0.05);②头颅CT单侧病变部位ONSD患侧与健侧相比,病变部位ONSD更高5.7(5.2~6.7)vs.5.4(5.1~5.9),P=0.001;③ONSD与头痛类型没有显著相关性(P>0.05);④合并基础疾病的头痛患者建议进行急诊超声ONSD初筛,尤其在糖尿病及肾功能不全的患者中。结论:床边超声检查视神经鞘直径是一种无创、简便易行的评估急诊颅内高压头痛患者的有效的初筛方法。
Objective:To explore the value of ultrasound measurement of optic nerve sheath diameter(ONSD)in the diagnosis of patients with intracranial hypertension with headache,compared with computed tomography(CT).Materials and Method:One hundred and twenty patients admitted to emergency room due to headache were enrolled prospectively.Of these,60 patients had an increased ONSD(≥5 mm)and 60 patients with normal ONSD(<5 mm).The ONSD measurement and the head CT examination were performed successively,and the results of the two examinations were compared.Result:①In patients with normal CT scan,the median left and right ONSD were 4.4(3.6-5.6)vs.4.3(3.6-5.5)mm,respectively.In patients with abnormal head CT,the median left and right ONSD were 5.3(5.1-6.5)vs.5.6(5.1-6.7)mm,there was no statistical difference between the two sides(P>0.05).②Compared with the healthy side,ONSD in the unilateral lesions of head CT was higher 5.7[(5.2-6.7)vs.5.4(5.1-5.9)mm,P=0.001].③There was no significant correlation between ONSD and headache type(P>0.05).④Headache patients with underlying disease were advised to perform emergency ultrasound ONSD screening,especially in patients with diabetes and renal insufficiency.Conclusion:Ultrasound examination of the optic nerve sheath at the bedside is a non-invasive and simple method for the evaluation of patients with emergency intracranial hypertension.
作者
王蕾
朱保锋
张毅
汪志峰
沈一鸣
储鑫
钱晨
WANG Lei;ZHU Baofeng;ZHANG Yi;WANG Zhifeng;SHEN Yiming;CHU Xin;QIAN Chen(Department of Emergency Center,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu,226001,China;Department of Neurosurgery,the Second Affiliated Hospital of Nantong University)
出处
《临床急诊杂志》
CAS
2020年第1期25-28,33,共5页
Journal of Clinical Emergency
基金
南通市卫计委科研项目(No:WKZL2018024)
南通市科技计划项目(No:JC2018101).
关键词
头痛
超声检查
视神经鞘直径
颅内压增高
headache
ultrasonography
optic nerve sheath diameter
intracranial hypertension
