Liu Guojing, Guo Zongduo, Sun Xiaochuan, Chai WeiNa, Qi Lingjun, Li Hui, Zheng Jianfeng, Guo Tengyun, He Zhaohui, Zhang Xiaodong, Zhu Ji, Luo Yetao
Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, China.
Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, China.
World Neurosurg. 2018 Oct;118:e269-e275. doi: 10.1016/j.wneu.2018.06.170. Epub 2018 Jun 30.
To detect cerebral autoregulation (CA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) by near-infrared spectroscopy and to assess its association with delayed cerebral ischemia (DCI).
From January to August 2017, 81 patients (average age 53.25 ± 10.27 years) were studied. Near-infrared spectroscopy was used to monitor CA, and associated factors were evaluated. Monitoring of CA was carried out at 5 time points (preoperative day 1 and postoperative days 1, 2, 3, and 7). Patients were sorted into 2 groups according to whether DCI occurred (DCI group and non-DCI group). The relationship between CA and DCI in patients with aSAH was analyzed.
Among 81 patients, CA trended toward being impaired in patients with aSAH with a poorer grade. DCI occurred in 39 of 51 (48.15%) patients with impaired CA. DCI occurred in 6 of 30 (7.4%) patients with intact CA.
Impaired CA monitored by near-infrared spectroscopy was shown in patients with aSAH before and after surgical intervention. Older age, smoking, hypertension, and especially impaired CA are independent risk factors for patients with DCI.
通过近红外光谱法检测动脉瘤性蛛网膜下腔出血（aSAH）患者的脑自动调节功能（CA），并评估其与迟发性脑缺血（DCI）的相关性。
2017年1月至8月，对81例患者（平均年龄53.25±10.27岁）进行研究。采用近红外光谱法监测CA，并评估相关因素。在5个时间点（术前第1天和术后第1、2、3、7天）进行CA监测。根据是否发生DCI将患者分为2组（DCI组和非DCI组）。分析aSAH患者CA与DCI之间的关系。
81例患者中，aSAH分级较差的患者CA有受损趋势。51例CA受损患者中有39例（48.15%）发生DCI。30例CA正常患者中有6例（7.4%）发生DCI。
手术干预前后的aSAH患者通过近红外光谱法监测到CA受损。年龄较大、吸烟、高血压，尤其是CA受损是DCI患者的独立危险因素。
