本文已被：浏览 224次 下载 146次
投稿时间：2025-06-30 网络发布日期：2026-01-27
投稿时间：2025-06-30 网络发布日期：2026-01-27
中文摘要: 目的 探讨脑干出血早期多模态监测体系的构建与应用价值。方法 回顾性分析 2023 年 9 月至 2024年9月邢台市中心医院收治的102例脑干出血患者的资料，根据改良Rankin 量表（mRS）评分将患者分为预后不良组（n=44）和预后良好组（n=58）。比较两组患者一般资料、实验室指标、早期多模态监测体系指标，包括大脑中动脉平均血流速度、脑灌注压、脑氧饱和度和脑组织氧分压，分析影响脑干出血患者预后不良的因素，并评估早期多模态监测体系预测脑干出血患者预后不良的价值。结果 预后不良组患者出血量、美国国立卫生研究院卒中量表（NIHSS）评分、血乳酸均高于预后良好组（P<0.05）；预后不良组患者大脑中动脉平均血流速度、脑灌注压、脑氧饱和度、脑组织氧分压均低于预后良好组（P<0.05）。出血量、NIHSS评分、大脑中动脉平均血流速度、脑灌注压、脑氧饱和度、脑组织氧分压均是影响脑干出血患者预后不良的独立影响因素（P<0.05）；四者联合检测的特异度、约登指数和曲线下面积分别为98.28%、0.801、0.934，均高于单一指标检测。结论 脑干出血预后不良患者早期多模态监测体系中大脑中动脉平均血流速度、脑灌注压、脑氧饱和度、脑组织氧分压均异常降低，临床监测其水平变化可作为预测预后不良的敏感指标，且联合预测价值更高。
Abstract:Objective To explore the value of the construction and application of an early multimodal monitoring system for brainstem hemorrhage. Methods A retrospective analysis was conducted on the data of 102 patients with brain stem hemorrhage admitted to Xingtai Central Hospital from September 2023 to September 2024. According to the Modified Rankin Scale（mRS），the patients were divided into a poor prognosis group（n=44）and a good prognosis group（n=58）.The general information and laboratory indicators of the two groups were compared. And the indicators of the early multimodal monitoring system between the two groups were compared，including mean flow velocity of the middle cerebral artery，cerebral perfusion pressure，cerebral oxygen saturation，and cerebral partial pressure of oxygen. The factors influencing poor prognosis in patients with brainstem hemorrhage were analyzed，and the value of the early multimodal monitoring system in predicting poor prognosis of patients with brainstem hemorrhage was also evaluated.Results The hemorrhage volume，National Institutes of Health Stroke Scale（NIHSS）score，and level of blood lactic acid in the poor prognosis group were higher than those in the good prognosis group（P<0.05）. The mean flow velocity of the middle cerebral artery，cerebral perfusion pressure，cerebral oxygen saturation，and brain tissue oxygen partial pressure in the poor prognosis group were all lower than those in the good prognosis group（P<0.05）. Hemorrhage volume，NIHSS score，mean flow velocity of the middle cerebral artery，cerebral perfusion pressure，cerebral oxygen saturation，and brain tissue oxygen partial pressure were all independent influencing factors for poor prognosis inpatients with brainstem hemorrhage（P<0.05）. The specificity，Youden index，and area under the curve（AUC）of the combined detection of the four indicators were 98.28%，0.801，and 0.934 respectively，which were higher than those of single indicator detection. Conclusion In the early multimodal monitoring system for patients with brain stem hemorrhage and poor prognosis，the mean flow velocity of the middle cerebral artery，cerebral perfusion pressure，cerebral oxygen saturation，and brain tissue oxygen partial pressure all decrease abnormally. Clinical monitoring of the changes in their levels can be used as sensitive indicators for predicting poor prognosis，and the combined prediction value is higher.
keywords: Brainstem hemorrhage Multimodal monitoring system Cerebral perfusion pressure Cerebral oxygen saturation Brain tissue oxygen partial pressure
文章编号： 中图分类号：R445 文献标志码：A
基金项目:邢台市市级科技计划经费项目（2024ZC214）
附件
| Author Name | Affiliation |
| HAN Dandan，SU Jianlong，YANG Lihui | Department of Neurosurgery,Xingtai Central Hospital,Xingtai,Hebei 054000,China |
引用文本：
韩聃聃， 苏建龙， 杨利辉.早期多模态监测预测脑干出血的预后[J].中国临床研究,2026,39(1):98-102.
韩聃聃， 苏建龙， 杨利辉.早期多模态监测预测脑干出血的预后[J].中国临床研究,2026,39(1):98-102.