眼部超声与颅内压监测课件

眼部超声与颅内压监测眼部超声与颅内压监测1OcularutrasoundGreggL.ChesneyPaulK.MohabirKEYPOINTSMeasurementotheoptcnervesheathdiameterONSD)byocularultrasoundprovdesarapid,noninvasivequanttativemethcdtoassessforelevatedintracranialpressureatthebedside,withameasurementof>5mmconsideredelevatedOcularultrasoundisavaluabletoolintheevaluationdfoculartraumaandcanbeusedoassessforforeignbody,globerupture,traumaticdetachments,lensdislocation,andvitreoushemorrageInpatientswithpainlessvisionloss,ocularultrasoundcanbeusedtoevaluateforposte-norvitreousdetachmentorretinaldetachmentandforthepresenoeofbloodfowinthecentralretinalarteryandveinOcularutrasound2解剖学基础解剖学基础3ipperldraturePupillaryaperature瞳孔cornearis虹膜AnteriorhambarCornea角膜ClarybodyCiliarybody睫状体ens晶状体vitreousbodyVitreousbody玻璃体ina视网膜Choroid脉络膜Sclera巩膜opticnenve-isopicnerveCertralretinalarteryandvEinFigure31.1NormalocUlaranatcmy.ipperld4elidComeauD2SHzAnterior一chamberIrisFigure31.2NormalutrasoundofVitreousbodytheeye.AnatomicstructuresthatRetinacanbevisuaizedonanormalocularutrasoundincudethecorneaante-Opticnerve-norchamber,iris,pupil,lens,vitreousbody,retina,andopticnerve.Theretinaappearsasasinglestructurealongwiththechoroidandscleraasthepostenorwalloftheglobeelid5视神经鞘是颅内硬脑膜与蛛网膜下腔的延续,因此颅内压増高将直接増大视神经鞘直径。测量主要在眼球后3mm处,因为该处随颅内压变化的弹性伸缩性最大。AO52%视神经鞘是颅内硬脑膜与蛛网膜下腔的延续,因此颅内压増高6测量方法测量方法7探头的选择和放置·1选择高频线阵探头(75MHzorgreater·2无菌贴膜覆盖眼球3充分耦合,避免挤压眼球(以面颊或者额头为受力点)·4深度在视网膜下1-2cm探头的选择和放置8Hgure31.3Propertransducerplacementtoobtaintransverseviews.Atransparentfilmdressingcow-Figure314Propertransducerplacementtoobtainerstheclosedeyelid.Thetransducerisheldlikeapen,andthefingersandpalmarerestedonthezygomaticarchandbridgeofthenosetostabilzethetransducer.NotethecopiousamountofgelusedtonotapplyanypressuretotheglobewiththetransduceHgure31.3Propertransducerp9esHFM80昌GuideMeon&xDualP:g:12es10眼部超声与颅内压监测课件11眼部超声与颅内压监测课件12眼部超声与颅内压监测课件13眼部超声与颅内压监测课件14眼部超声与颅内压监测课件15眼部超声与颅内压监测课件16眼部超声与颅内压监测课件17眼部超声与颅内压监测课件18眼部超声与颅内压监测课件19眼部超声与颅内压监测课件20眼部超声与颅内压监测课件21眼部超声与颅