视神经鞘直径与颅内压课件.ppt

1、Pulillary aperature Pulillary aperature 瞳孔瞳孔Iris Iris 虹膜虹膜Cornea Cornea 角膜角膜Ciliary body Ciliary body 睫状体睫状体Lens Lens 晶状体晶状体Vitreous body Vitreous body 玻璃体玻璃体Retina Retina 视网膜视网膜Choroid Choroid 脉络膜脉络膜Sclera Sclera 巩膜巩膜 视路视路MRIMRI图像图像 视神经：视神经：眼内部眶部（ONSD段）管内部颅内部Critical Care 2008,12:R114ONSD视神经ONSD临界值

2、5.82mm ICP20mmHg 共纳入231例敏感性 0.90（95%CI 0.80-0.95）特异性 0.85（95%CI 0.73-0.93）Intensive Care Med(2011)37:10591068影响因素most effective in distinguishing a hypothetical change in ICP between supine and prone positioning(0.86+/-0.034 0.79 to 0.92).A cutoff of 0.43 cm was found to be a best separator of ONSD

3、value between supine and prone with a specificity of 75.0 and a sensitivity of 86.7.Conclusions:Noninvasive ICP estimation may be useful in patients at risk of developing intracranial hypertension who require prone positioning.Journal of Neurosurgical Anesthesiology.18 March 2016 There were 62 subje

4、cts,28 females(45.2%)and 34 males(54.8%),with a mean age of 44.22 10.44 years(range 2366).Forty-eight percent of patients were non-obese,and 52%of patients were obese.The mean body mass index was 30.70 7.61 kg/m2(range 20.059.5).The mean ONSD of non-obese and obese patients was 4.7 and 5.5 mm 4.7 an

5、d 5.5 mm at baseline(p=0.01),5.4 and 6.2 mm 5.4 and 6.2 mm at 15 min(p=0.01),5.8 5.8 and 6.6 mm and 6.6 mm at 30 min(p=0.01),and 5.1 and 5.7 mm 5.1 and 5.7 mm after deflation of pneumoperitoneumpneumoperitoneum(p=0.03),respectively.Surgical EndoscopyJune 2016,Volume 30,Issue 6,pp 23212325测量方法ONSD评估颅内压力测量方法：冠状位测量球后3mm处ONSD,3次均值正常上限值5mm矢状位测量球后3mm 处ONSD,3次均值正常上限值5.8mm参考值