中国实用神经疾病杂志2025，Vol.28Issue(9)：1163-1167,5.DOI:10.12083/SYSJ.240565
换能器位置对重症蛛网膜下腔出血患者脑灌注压测量准确性的影响
Effect of transducer position on accuracy of cerebral perfusion pressure measurement in severe subarachnoid hemorrhage patients
摘要
Abstract
Objective To investigate the impact of transducer position on accuracy of cerebral perfusion pressure(CPP)measurement in patients with severe subarachnoid hemorrhage(SAH)when the head of bed is elevated to 30°.Methods A self-controlled before-and-after continuous enrollment method was used to select 52 severe SAH patients from the Neurosurgery ICU of Xuanwu Hospital,Capital Medical University from June 2019 to June 2023.Data were collected at 09:00 on the first,second,and third day after lateral ventricular drainage tube placement,with three sets of data per patient.All enrolled patients used sterile hydraulic transducers connected to the lateral ventricular drainage tube and radial/brachial arterial sheath,which were then connected to the monitoring device's pressure measuring module.The standard supine position CPP was compared with the CPP when the head of bed was elevated to 30°and both transducers were placed at the level of the external auditory canal,and when the transducer position remained unchanged after elevating the head of bed.Patients were divided into two groups based on intracranial pressure(ICP)≥20 mmHg(1 mmHg=0.133 kPa)and<20 mmHg in the supine position,and the difference on CPP between the supine and elevated head positions was compared.Results CPP when the head of bed was elevated to 30° and both transducers were at the level of external auditory canal was(79.64±16.34)mmHg,compared to the standard supine position CPP of(81.26±15.69)mmHg,showing no significant difference(t=1.722,P=0.087).However,there was a significant difference on CPP between the unchanged transducer position after head elevation(83.27±17.56)mmHg and when both transducers were at the level of external auditory canal(t=5.342,P<0.001).For patients with ICP≥20 mmHg,the standard supine position CPP was(79.64±16.02)mmHg,compared to(77.06±14.14)mmHg when the head was elevated to 30°,showing a significant difference(t=2.363,P=0.021).Conclusion After elevating the head of bed to 30°in severe SAH patients,nurses should place both pressure transducers at the level of external auditory canal for more accurate CPP measurement.For patients with high intracranial pressure,clinical nursing should reduce the frequency of head elevation and sudden rapid changes in body position to prevent the risk of cerebral ischemia.关键词
重症蛛网膜下腔出血/床头抬高/脑灌注压/体位护理/换能器位置Key words
Severe subarachnoid hemorrhage/Raising of the head of bed/Cerebral perfusion pressure/Position care/Transducer position分类
医药卫生引用本文复制引用
王娜,张娜芹,崔丽,欧梦仙,李艳菲,赵朋朋,纪媛媛,王军..换能器位置对重症蛛网膜下腔出血患者脑灌注压测量准确性的影响[J].中国实用神经疾病杂志,2025,28(9):1163-1167,5.基金项目
国家科技部雄安新区科技创新专项——新型急性神经系统疾病救治体系优化和平台建设(编号:2023XAGG0072) （编号:2023XAGG0072）
