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经颅多普勒对原发性脑出血病人脑血流的监测

Transcranial Doppler in the monitoring of primary intracerebral hemorrhage

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【作者】 王冰胡世颉李兵高大宽胡学安刘伟曹宝萍费舟

【Author】 Wang Bing;Hu Shijie;Li Bing;Gao Dakuan;Hu Xuean;Liu Wei;Cao Baoping;Fei Zhou;Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University;

【机构】 第四军医大学西京医院神经外科

【摘要】 目的探讨经颅多普勒(transcranial doppler,TCD)对原发性脑出血(primary intracerebral hemorrhage,PICH)病人脑血流量和颅内压的监测作用。方法回顾性分析80例CT确诊PICH病例资料,采用TCD监测大脑中动脉(middle cerebral artery,MCA)血流动力学指标和血流频谱变化。结果与自身健侧比较,出血后3 d、7 d、21 d出血侧搏动指数(pulsatility index,PI)明显升高(P<0.05)。当PI>1.0,阻力指数(resistance index,RI)>0.6时,应考虑颅内压升高。结论 TCD血流频谱可作为监测颅内压辅助指标,采用TCD监测PICH病人脑血流变化,部分参数与颅内压有一定相关性,可间接了解颅内压改变,是临床治疗和预后评估的重要参考依据。

【Abstract】 Objective To investigate the application of transcranial Doppler(TCD) in the brain blood flow and intracranial pressure(ICP) monitoring of primary intracerebral hemorrhage(PICH). Methods The clinical data of 80 patients with PICH diagnosed by computed tomography scan were analyzed retrospectively. TCD was applied to detect cerebral vascular hemodynamic index and blood flow spectrum of the middle cerebral artery(MCA). Results Compared with the healthy side, the pulsatility index(PI) of the bleeding side was significantly increased 3, 7, 21 d after PICH(P <0.05). PI>1.0 and resistance index(RI)>0.6 was a reflection of elevation of ICP. Conclusions TCD blood flow spectrum of should be considered as the second indicator of ICP monitoring. The parameters of TCD could reflect the changes of brain blood flow and ICP, which may be helpful for the diagnosis, treatment and prognosis assessment of PICH.

【基金】 国家自然科学基金青年科学基金项目(编号:81101710)
  • 【文献出处】 中国微侵袭神经外科杂志 ,Chinese Journal of Minimally Invasive Neurosurgery , 编辑部邮箱 ,2015年02期
  • 【分类号】R743.34
  • 【被引频次】8
  • 【下载频次】125
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