■研究通过使用电生物阻抗和近红外光谱(NIRS)在儿科神经重症监护中获得的干扰系数(DC)和区域脑氧饱和度(rSO2)的临床意义。
■我们将45例小儿患者作为损伤组,70例健康儿童作为对照组。DC由通过时间电极的0.1mA-50kHz电流的阻抗分析得出。rSO2是从前额上反射的NIR光测量的氧合血红蛋白的百分比。损伤组在手术后6、12、24、48和72h以及对照组在健康筛查门诊就诊期间获得DC和rSO2。我们比较了两组之间的DC和rSO2,它们在损伤组中随时间的变化及其与颅内压(ICP)的相关性,脑灌注压(CPP),格拉斯哥昏迷量表(GCS)评分,格拉斯哥结果量表(GOS)评分,以及诊断术后脑水肿和预测不良预后的能力。
■损伤组的DC和rSO2明显低于对照组。在损伤组中,ICP在监测期间有所增加,而DC,CPP和rSO2降低。DC与ICP呈负相关,与GCS评分、GOS评分呈正相关。此外,在有脑水肿体征的患者中观察到较低的DC值,DC值为86.5或以下,提示6-16岁患者存在脑水肿。另一方面,rSO2与CPP呈正相关,GCS评分,和GOS得分,值为64.4%或以下,表明预后不良。CPP降低是rSO2降低的独立危险因素。
■基于电生物阻抗和近红外光谱的DC和rSO2监测不仅反映了脑水肿和氧合的程度,还能反映疾病的严重程度和预测患者的预后。这种方法提供了一个实时,床边,评估脑功能和检测术后脑水肿和不良预后的准确方法。
UNASSIGNED: To investigate the clinical significance of the disturbance coefficient (DC) and regional cerebral oxygen saturation (rSO2) as obtained through the use of electrical bioimpedance and near-infrared spectroscopy (NIRS) in pediatric neurocritical care.
UNASSIGNED: We enrolled 45 pediatric patients as the injury group and 70 healthy children as the control group. DC was derived from impedance analysis of 0.1 mA-50 kHz current via temporal electrodes. rSO2 was the percentage of oxyhemoglobin measured from reflected NIR light on the forehead. DC and rSO2 were obtained at 6, 12, 24, 48 and 72 h after surgery for the injury group and during the health screening clinic visit for the control group. We compared DC and rSO2 between the groups, their changes over time within the injury group and their correlation with intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, Glasgow outcome scale (GOS) score, and their ability to diagnose postoperative cerebral edema and predict poor prognosis.
UNASSIGNED: DC and rSO2 were significantly lower in the injury group than in the control group. In the injury group, ICP increased over the monitoring period, while DC, CPP and rSO2 decreased. DC was negatively correlated with ICP and positively correlated with GCS score and GOS score. Additionally, lower DC values were observed in patients with signs of cerebral edema, with a DC value of 86.5 or below suggesting the presence of brain edema in patients aged 6-16 years. On the other hand, rSO2 was positively correlated with CPP, GCS score, and GOS score, with a value of 64.4% or below indicating a poor prognosis. Decreased CPP is an independent risk factor for decreased rSO2.
UNASSIGNED: DC and rSO2 monitoring based on electrical bioimpedance and near-infrared spectroscopy not only reflect the degree of brain edema and oxygenation, but also reflect the severity of the disease and predict the prognosis of the patients. This approach offers a real-time, bedside, and accurate method for assessing brain function and detecting postoperative cerebral edema and poor prognosis.