【摘要】 目的　观察脑出血患者行微创血肿抽吸引流术前后TCD参数的变化 ,试图评价该手术对脑灌注的影响。方法　动态监测 6 0例发病 12小时内入院的脑出血患者的血压 ,并于入院时和入院后第 1、3、7、14天行TCD监测 ,其中 4 0例入院 2 4小时内接受血肿抽吸引流术 (手术组 ) ,2 0例行内科常规治疗 (对照组 )。结果　两组患者治疗过程中血压逐渐下降 ,手术组血压下降幅度较对照组大 ,第 14天收缩压差异显著 (P <0 0 1)。双侧大脑中动脉 (MCA)流速呈先降后升 ,双侧脉动指数 (PI)值呈先升后降。手术组第 7天MCA流速即开始升高 ,PI值降低 ,且在第 14天两组间差异显著 (P <0 0 5 ) ;对照组MCA流速于 1周内呈下降改变 ,而第2周开始升高 ,PI值改变与之相反。手术组平均住院日较对照组短 (P <0 0 1)。结论　微创血肿引流术可显著性改善脑出血患者的脑灌注更多还原

【Abstract】 Objective To observe the changes of TCD parameters presurgery and postsurgery in the patients with acute intracerebral hemorrhage (ICH),and try to evaluate the effects of surgery on cerebral perfusion.Methods The blood pressure(BP) of 60 patients with intracerebral hemorrhage was monitored within the first 12 hours after clinical onset,and they were monitored by TCD in the 1st, 3rd,7th,and 14th day after clinical onset, among them, 40 patients were treated by medicine and stereotactic computed tomographic (CT) guided drain and aspiration within the first 24 hours, 20 patients were only treated by medicine (the control group).Results BP of ICH patients gradually reduced during the period of therapy, while middle cerebral artery blood flow velocity (MFV) decreased in the early days then increased,PI increased firstly and then decreased,but there was a remarkable difference in the two groups.in the fourteenth day,comparing the TCD parameters of two groups( P < 0 05 ).In the surgery group PI decreased while MFV began to increase in the 7th day,and there was remarkable difference between the two groups in 14th day( P < 0 05 ).In the control group decreased in first week,and then increased in the second week.PI changed in oposite.BP decreased greatly in the surgery group.There was significant difference in BP and the TCD parameters in the fourteenth day ( P <0 01). Conclusion Therapy of stereotactic computed tomographic (CT) guided drain and aspiration can improve cerebral perfusion in acute intracerebral hemorrhage.更多还原