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目的对比经颅多普勒在颅内感染与脑出血初期颅高压中的预测准确性。方法 50例颅内感染患者作为甲组,50例脑出血患者作为乙组。甲组行132次腰穿,乙组行142次腰穿,进行腰穿测压前均实施经颅多普勒超声检查。结果两组患者的格拉斯哥昏迷量表(GCS)评分以及颅内压(ICP)水平比较差异无统计学意义(P>0.05),血流速度(Vs、Vm、Vd)、平均动脉压(MAP)以及脑灌注压(CPP)对比差异具有统计学意义(P<0.05);甲组ICP阳性预测率是64.39%,CPP阳性预测率是62.88%;乙组ICP阳性预测率是90.14%,CPP阳性预测率是90.14%,乙组的TCD参数预测ICP与CPP的准确率要显著高于甲组(P<0.05)。结论颅内感染按照特征性TCD参数变化能够对ICP与CPP进行准确预测,但是TCD特征性参数变化对脑出血的预测准确率要显著优于颅内感染。
Objective To compare the predictive accuracy of transcranial Doppler in intracranial infection and early stage of cerebral hemorrhage. Methods 50 patients with intracranial infection as a group, 50 patients with cerebral hemorrhage as B group. A group of 132 lumbar puncture, B group of 142 lumbar puncture, lumbar puncture were performed before transcranial Doppler ultrasound. Results There was no significant difference in Glasgow coma scale (GCS) score and intracranial pressure (ICP) between the two groups (P> 0.05), blood flow velocity (Vs, Vm, Vd), mean arterial pressure (MAP) (P <0.05). The positive predictive value of ICP in group A was 64.39%, the positive predictive value of CPP was 62.88%, the positive predictive value of ICP in group B was 90.14%, and the positive predictive value of CPP The rate of TCD in group B was significantly higher than that in group A (P <0.05). Conclusions ICP and CPP can be accurately predicted by the change of characteristic TCD parameters in intracranial infection. However, the predictive accuracy of characteristic parameters of TCD for intracerebral hemorrhage should be significantly better than that of intracranial infection.