Shaanxi Provincial People's Hospital, Xi'an, 710086, Shaanxi, China.
Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, Guangdong, China.
Acta Neurol Belg. 2023 Oct;123(5):1815-1821. doi: 10.1007/s13760-022-02037-5. Epub 2022 Aug 27.
Our study aimed to investigate the predictive value of intracranial pressure (ICP) and cerebral oxygen metabolism monitoring in the postoperative prognosis of patients with spontaneous intracerebral hemorrhage (SICH).
The clinical data of 55 patients with SICH treated by neurosurgery were analyzed retrospectively. These patients were divided into two groups based on postoperative Glasgow Outcome Scale (GOS) scores, i.e., the poor prognosis group (GOS I-III) and the good prognosis group (GOS IV and V). Next, the ICP and cerebral oxygen metabolism indexes, such as brain temperature (BT), cerebral perfusion pressure (CPP), internal jugular venous oxygen saturation (SjvO), and arterial partial pressure of carbon dioxide (PaCO), were recorded after the operation. Further, the prognostic differences between the two groups were compared, and the predictive values were evaluated using the receiver operating characteristic curve (ROC) and area under the curve (AUC).
The results showed that the average ICP and BT in the good prognosis group were lower than those in the poor prognosis group. However, the CPP and SjvO in the good prognosis group were higher than those in the poor prognosis group. Moreover, the incidence of low PaCO in the poor prognosis group was higher than that in the good prognosis group.
Our results demonstrated that the average ICP, BT, CPP, SjvO, and arterial PaCO may reflect the changes in brain function and cerebral blood flow, which are significantly correlated with the prognosis of patients. Further, our findings indicated that the combined postoperative ICP levels with cerebral oxygen metabolism indexes could guide clinical treatments and predict prognosis.
本研究旨在探讨颅内压（ICP）和脑氧代谢监测对自发性脑出血（SICH）患者术后预后的预测价值。
回顾性分析了 55 例接受神经外科治疗的 SICH 患者的临床资料。根据术后格拉斯哥预后评分（GOS）将这些患者分为预后不良组（GOS I-III）和预后良好组（GOS IV 和 V）。然后，记录术后 ICP 和脑氧代谢指标，如脑温（BT）、脑灌注压（CPP）、颈内静脉血氧饱和度（SjvO）和动脉二氧化碳分压（PaCO）。进一步比较两组之间的预后差异，并使用受试者工作特征曲线（ROC）和曲线下面积（AUC）评估预测值。
结果显示，预后良好组的平均 ICP 和 BT 均低于预后不良组，而 CPP 和 SjvO 则高于预后不良组。此外，预后不良组低 PaCO 的发生率高于预后良好组。
本研究结果表明，平均 ICP、BT、CPP、SjvO 和动脉 PaCO 可能反映了脑功能和脑血流的变化，与患者的预后显著相关。进一步研究发现，术后 ICP 水平与脑氧代谢指标的联合应用可以指导临床治疗和预测预后。
