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通过无创颅内压波形分析预测小儿脑积水颅内高压

Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus.

作者信息

Ballestero Matheus Fernando Manzolli, Frigieri Gustavo, Cabella Brenno Caetano Troca, de Oliveira Sergio Mascarenhas, de Oliveira Ricardo Santos

机构信息

Division of Pediatric Neurosurgery of the Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, São Paulo, Brazil.

Institute of Advanced Studies, University of São Paulo, Sao Carlos, Sao Paulo, Brazil.

出版信息

Childs Nerv Syst. 2017 Sep;33(9):1517-1524. doi: 10.1007/s00381-017-3475-1. Epub 2017 Jun 16.

Abstract

PURPOSE

The purpose of this study is to evaluate a noninvasive device to assess intracranial pressure wave form in children with hydrocephalus.

METHODS

A prospective and non-experimental descriptive-analytic study was performed. Fifty-six patients were enrolled in this study. They were divided in four groups: group A, children with clinically compensated hydrocephalus; B, surgically treated hydrocephalus; C, patients with acute intracranial hypertension due to hydrocephalus; and D, children without neurological disease (control). Data were collected through the installation of an extracranial deformation sensor, coupled to the children's scalp, which allowed registration of noninvasive intracranial pressure curves. Parameters obtained were analyzed: P2/P1 ratio, "classification P1 and P2 and P1 slope.

RESULTS

P2/P1 index and "classification of P1 and P2" had a sensitivity of 80% and specificity of 100% for predicting intracranial hypertension. "P1 slope" presented no statistical difference.

CONCLUSION

This study showed a useful and noninvasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.

摘要

目的

本研究旨在评估一种用于评估脑积水患儿颅内压波形的非侵入性设备。

方法

进行了一项前瞻性非实验性描述性分析研究。本研究纳入了56例患者。他们被分为四组:A组,临床代偿性脑积水患儿;B组,接受手术治疗的脑积水患儿;C组,因脑积水导致急性颅内高压的患者;D组,无神经系统疾病的儿童(对照组)。通过安装与儿童头皮相连的颅外变形传感器收集数据,该传感器可记录非侵入性颅内压曲线。对获得的参数进行分析:P2/P1比值、“P1和P2分类”以及P1斜率。

结果

P2/P1指数和“P1和P2分类”在预测颅内高压方面的敏感性为80%,特异性为100%。“P1斜率”无统计学差异。

结论

本研究显示了一种用于监测颅内压的有用且非侵入性的方法,该方法能够指示脑积水患儿的颅内高压,因此,应进一步研究其临床应用。

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