预警基底节脑出血后颅内压失代偿性增高的磁感应相位移技术研究

Stroke remains a significant cause of morbidity and mortality in china. More than 70% is cerebral hemorrhage in basal ganglia. Early warning of intracranial hypertension after cerebral hemorrhage in basal ganglia is important. Intracranial compliance is an important clinical parameter because it determines the ability of the intracranial space to accommodate an increase in volume without a large increase in intracranial pressure (ICP).It was recently found that cerebrospinal fluid pulse wave (CSFPW) amplitude has a predictive value for shunt response. It is well known that CSFPW usually contain episodes of transient ICP elevation in the positive phase of the wave, during which amplitude of CSFPW. Unfortunately, detecting the presence of CSFPW noninvasively is not straightforward. In the present work, we proposed a new non-contact noninvasive approach to detect and separate periods of ICP slow waves from those of in an overnight ICP recording with magnetic induction phase shift method (MIPS). MIPS method is a simple and reliable new method for the evaluation of intracranial hypertension after cerebral hemorrhage in basal ganglia.

脑卒中是我国居民第一位的死亡原因。基底节脑出血占出血性脑卒中的70%以上，其中颅内压增高是致死致残的主要原因。研究基底节脑出血后颅内压失代偿性增高的变化规律，能够帮助临床在代偿能力耗尽后ICP急剧增高前作出及时的医护处理，减少继发脑损伤的概率，降低基底节脑出血的致死致残率。本项目提出了一种基于无创非接触磁感应相移技术的预警基底节脑出血后颅内压增高的技术方法。根据脑脊液和脑血液同频不同相的信号特点，改进设计独立变量分离传感器。通过动物实验和临床预实验，采集脑脊液搏动波的MIPS信号，进行降噪处理及P1、P2幅度面积等特征量识别提取，结合脑脊液动力学变化规律，并与有创方法测量的ICP均值进行相关性研究和回归分析，探讨MIPS技术用于脑出血早期评估的临床应用价值。本研究可望为临床提供一种新型的无创非接触、可实时监测基底节脑出血后颅内压失代偿性增高的新方法，为临床及时干预提供早期预警指标。

脑卒中是我国居民第一位的死亡原因。基底节脑出血占出血性脑卒中的70%以上，其中颅内压增高是致死致残的主要原因。研究基底节脑出血后颅内压(ICP, intracranial pressure)失代偿性增高的变化规律，能够帮助临床在代偿能力耗尽后颅内压急剧增高前作出及时的医护处理，减少继发脑损伤的概率，降低基底节脑出血的致死致残率。本项目提出了一种基于无创非接触磁感应相移技术(MIPS, magnetic induction phase shift)的预警基底节脑出血后颅内压增高的技术方法。首先设计了适合临床需求并且符合人体工学的眼镜架式可穿戴传感器。该传感器在15.1MHz的激励频率下有着优秀的灵敏度和特异度。通过动物实验、统计学分析和病理学对比验证研究，提出一个能够反映脑部疾病早期进展的有效参数BESI (severity of brain edema )。同时开展了脑出血磁感应监护仪监测脑出血的临床研究，提取分析了脑出血患者术后多个时刻的磁感应信号和颅内压信号。动物实验和临床试验都验证了该监测方法能够在代偿功能耗尽导致ICP均值增高和影像学形态显著改变前，能够用于指导脑出血早期的诊断和治疗，节约救治时间，有潜力降低基底节脑出血的致死致残率。