通讯作者: 陈势, 652450999@qq.com

DOI：10.12201/bmr.202412.00037

Prognostic value of measuring optic nerve sheath diameter at different times for assessment of neurological prognosis in cardiac arrest patients

• 摘要：目的：探讨在心搏骤停（cardiac arrest，CA）患者自主循环恢复（return of spontaneous circulation，ROSC）后不同时间测量视神经鞘直径（optic nerve sheath diameter，ONSD）评估神经功能预后的价值。方法：采用前瞻性观察研究，选择2021年3月至2024年6月期间温州市中西医结合医院CA复苏成功后转入ICU的昏迷患者为研究对象。使用超声测量患者ROSC后初始、12～24小时、第2天、第3天的ONSD。根据治疗后3个月的脑功能评分（cerebral performance categories，CPC）将患者分为神经功能不良组（CPC 3～5分）和神经功能良好组（CPC 1～2分）。绘制受试者工作特征曲线，分析各时间ONSD测量值对CA患者神经功能预后的预测价值。结果：共纳入48例患者，其中神经功能不良组神经功能良好组各24例。ROSC后初始阶段两组患者ONSD的差异没有统计学意义（P=0.061），曲线下面积（area under the curve，AUC）为0.665；12～24小时、第2天、第3天两组患者ONSD的差异均有统计学意义（均P<0.001），AUC分别为0.785、0.837和0.841。结论：在CA患者ROSC后12～24小时、第2天、第3天超声测量ONSD，对预测神经功能预后有较好的价值，其中第2天测量ONSD可能是评估CA后患者神经功能预后的最佳时机。

  关键词： 心搏骤停; 视神经鞘直径; 预后; 超声检查

   

  Abstract: Objective: This study aimed to investigate the value of measuring optic nerve sheath diameter(ONSD) at different times after the return of spontaneous circulation (ROSC) in evaluating the neurological function prognosis of post-CA patients. Methods: This was a prospective observational study. Comatose patients successfully resuscitated from CA and transferred to the ICU in Wenzhou Traditional Chinese Medicine and Western Medicine Combined Hospital from March 2021 to June 2024 were selected as the research subjects. The ONSD of the patients was measured using ultrasonography at the initial, 12～24 hours, day 2, and day 3 after ROSC. Based on the Cerebral Performance Categories (CPC) at three months post-treatment, the patients were categorized into two groups: the poor outcome group (CPC 3～5 points) and the good outcome group (CPC 1～2 points). The Receiver operating characteristic curves of the subjects were plotted to compare the values for predicting neurologic outcomes of post-CA patients. Results: 48 patients were included, 24 in the poor outcome group and 24 in the good outcome group. The difference in ONSD between the two groups of patients initially after ROSC was not statistically significant, and the area under the curve (AUC) was 0.665; the differences in ONSD between the two groups at 12 to 24 hours, day 2, and day 3 were statistically significant, and the AUCs were 0.785, 0.837, and 0.841 respectively. Conclusion: Measuring the ONSD by ultrasonography at 12～24 hours, day 2, and day 3 after ROSC in post-CA patients has good value in predicting neurologic prognosis. Measurement of ONSD on day 2 may be the optimal time to evaluate the neurological prognosis of patients after CA.

  Key words: Cardiac arrest; Optic nerve sheath diameter; Prognostic; Ultrasonography

  提交时间：2024-12-14

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• 序号	提交日期	编号	操作
  1	2024-11-20	bmr.202412.00037V1	下载

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