额部肿瘤切除时枕部监测PSI的可行性研究。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-09-03 DOI:10.1016/j.wneu.2025.124425

Ya-xian Huang , Wei Xiao , Chun-xiu Wang , Tian-long Wang

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引用次数: 0

摘要

背景：由于手术视野干扰，额叶肿瘤切除术时，额叶患者状态指数（PSI）监测是不切实际的。目前不存在有效的替代监测位置。本研究评估了标准额部和实验性枕部PSI监测之间的一致性。方法：采用SEDline镇静监测仪记录16例额叶肿瘤切除术患者额枕部PSI值。从传感器附着到头框固定，每隔2秒收集一次PSI数据。使用Bland-Altman分析和类内相关系数（ICC）评估一致性。亚组分析评估了美国麻醉医师协会（ASA）分类（I/II/III）和肿瘤侧边的影响。Passing-Bablok回归在七个关键时间点建立了额部和枕部PSI之间的预测方程。结果：额部和枕部PSI趋势表现出高度的时间同步性（P = 0.08），且呈强正相关（R2 = 0.805, P < 0.001）。Bland-Altman分析显示了极好的一致性（平均对数变换差：-0.02;95% LoA: -0.82至0.80）。所有数据的ICC为0.82 （95% CI: 0.816-0.830, P < 0.001）。ASA分型（P = 0.368）和肿瘤侧位（P = 0.382）对额枕PSI差异均无显著影响。采用passingbablok回归方程预测枕部PSI:ePSI=0.37×（zPSI）1.28。结论：枕部PSI与额部PSI在额部肿瘤切除术中表现出良好的一致性，为阻塞的额部监测提供了可行的替代方案。

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Occipital Monitoring of Patient State Index During Frontal Tumor Resection: A Feasibility Study

Background

Frontal patient state index (PSI) monitoring is impractical during frontal lobe tumor resection due to surgical field interference. No validated alternative monitoring positions exist currently. This study evaluated the agreement between standard frontal and experimental occipital PSI monitoring.

Methods

A SedLine sedation monitor was used to record frontal and occipital PSI values in 16 patients who underwent frontal lobe tumor resection. PSI data were collected at 2-second intervals starting from sensor attachment to headframe fixation. Agreement was assessed using the Bland-Altman analysis and intraclass correlation coefficient. Subgroup analyses evaluated tumor laterality. A Passing-Bablok regression established predictive equations between frontal and occipital PSI at 7 critical time points.

Results

Frontal and occipital PSI trends showed high temporal synchrony (P = 0.08) with a strong positive correlation (R² = 0.805, P < 0.001). Bland-Altman analysis demonstrated excellent agreement (mean log-transformed difference: −0.02; 95% limits of agreement: −0.82 to 0.80). The intraclass correlation coefficient of all data was 0.82 (95% confidence interval: 0.816–0.830, P < 0.001). Tumor laterality did not significantly affect frontal–occipital PSI differences (P = 0.382). A Passing-Bablok regression equation was derived to predict frontal PSI from occipital measurements:

e P S I = 0.37 \times {(z P S I)}^{1.28}

Conclusions

Occipital PSI demonstrates excellent agreement with frontal PSI during frontal tumor resection, offering a viable alternative to obstructed frontal monitoring. Prospective validation via multi-center continuous intraoperative monitoring constitutes the essential next step.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS