儿童内出血中的内压力轨迹和功能结果:基于组的轨迹建模分析
Lijuan Zhang1, Xiaomin Cui1, Ming Zhang1
1Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, No.72 Guangzhou Road, Nanjing, 210008, Jiangsu Province, China.
European journal of pediatrics
|September 3, 2025
概括
在患有内出血 (ICH) 的儿科患者中,对内血压 (ICP) 的监测至关重要. 这项研究确定了不同的ICP轨迹模式,揭示了某些动态ICP模式与不良的神经结果有关.
科学领域:
- 儿童神经学
- 神经临床护理
- 临床结果研究
背景情况:
- 脑内血压 (ICP) 对儿童脑内出血 (ICH) 的结果至关重要.
- 现有研究主要使用静态ICP测量,缺乏对纵向模式的洞察力.
研究的目的:
- 在患有内出血 (ICH) 的儿科患者中识别明显的内压力 (ICP) 轨迹.
- 评估这些ICP模式对临床结果的影响.
- 探索ICP动态和六个月的功能结果之间的关联.
主要方法:
- 使用基于小组的轨迹建模 (GBTM) 来分析小儿ICH患者的每小时的ICP数据.
- 计算了短期ICP波动 (ΔICP),以评估ICP的动态.
- 多变量逻辑回归分析了ICP轨迹与六个月结果之间的关联.
主要成果:
- 在201名儿科ICH患者中确定了五种不同的ICP轨迹.
- 在机械通风,血管活性剂使用,瞳孔反应性,脑切除,ICP值,ΔICP变异性,GCS和pGOSE得分方面观察到显著差异.
- "高波动"和"中期稳定可变"ICP轨迹组显示六个月不良结果的几率明显较高.
结论:
- 在ICH儿童中,ICP轨迹存在显著的异质性.
- 三种已识别的ICP轨迹模式与不良的神经结果有显著联系.
- 描述动态ICP子类型可以帮助早期风险分层和了解ICP法规.
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