Clinical Value Of Intracranial Pressure Wave Parameters On Perioperation Of Intracranial Aneurysm

Objective:Aneurysm Subarachnoid Hemorrhage(aSAH)is an acute severe cerebrovascular disease with high mortality and morbidity.High intracranial pressure(ICP)and global cerebral edema(GCE)were the important reason of high mortality and morbidity after aSAH.GCE also was the reason of high intracranial pressure,However,there is very little research on it and the identification method is single.compared to ICP,ICP wave parameters covers more intracranial information of brain tissue compliance.ICP compensatory capacity and cerebrovascular reactivity,may help us to further identify and know GCE.In our investigation,the clinical data and ICP monitoring data were collected and ICP wave parameters were analyzed.then we explored clinical value of ICP wave parameters and the correlation with GCE.Methods:1.ICP of aSAH patients with intracranial aneurysm clipping was continuously monitored after operation during November 2016-November 2017.The ICP wave parameters:Mean intracranial pressure(MICP)?Mean intracranial pressure wave amplitude(MWA)?correlation coefficient between ICP amplitude and mean pressure(RAP)were analyzed and calculated.2.The relations of MICP?MWA and the preoperative and postoperative clinical state and The correlation of ICP wave parameters with GCE were analyzed.Results:1.In these patients whose preoperative clinical state were better,the value of MICP?MWA are lower.There are significant difference among the MWA and MICP of postoperative GCS groups.2.There were negative correlation of the postoperative GCS score with MICP(r = 0.619,p<0.05),the MWA(r = 0.782,p<0.05).Compared with MICP,the correlation of MWA with GCS score is more significant.3.The difference of mFisher.MWA and RAP were significant between NO-GCE group and GCE group.4.The result of multiple-factor analysis shows that mFisher(OR=8.738:95%CI1.541-49.560:P=0.014)?RAP(OR=2.413:95%CI1.334-4.363:P=0.004)were the independent risk factors of GCE.Conclusion:1.The parameters of intracranial pressure wave can effectively indicate the clinical performance of patients.The MWA and MICP are valuable indicators to assist monitoring and management of aSAH patients.2.The mFisher and RAP were the independent risk factors of GCE.Therefore,monitoring of RAP can help distinguish the occurrence of GCE...