【摘要】 目的探讨TCD对昏迷患者预后评估的作用。方法对67例昏迷患者按Glasgow评分进行分组并进行1～5d的动态观察。结果≤3分组表现为收缩期小尖峰信号,舒张期无信号,收缩期狭小尖峰信号,舒张反流,无信号组的表现预后最差。Glasgow评分4～7分患者血流速度明显降低,频谱相对正常预后有加重趋势,时间较长无变化者可能预示植物状态。血流速度减慢明显及过度灌注伴颅内压增高者预后较差。血流速度不稳定发生在Glasgow评分≤5分多可能预后不良,若Glasgow评分≥6分提示预后良好。血流速度加快预示可能有脑血管痉挛一般预后尚可,频谱形态正常,血流速度正常及血流速度无变化多提示预后较佳。结论TCD对昏迷患者预后评估有重要作用。更多还原

【Abstract】 Objective To research the prognosis evaluation effect of TCD for coma patients. Methods 67 patients were divided into several groups by Glasgow grades and followed with observation from the first to fifth day.Results In group which Glasgow grades ≤3, the features of TCD are small systolic for-ward flow and no flow in diastolic phase, the prognosis is worst in small systolic for-ward flow, retrograde diastolic flow and no flow. There is aggravation tendency for patients in group which Glasgow grade 4 to 7 and whose flow velocity very slow and spectra relatively normal, and could be persistent vegetative status in those patients who survive for long time. The prognosis of patients with blood flow rate very slow and hyperperfusion complicated with increased intracranial pressure is worse. Prognosis of patients with blood flow rate instability is worse in patients with Glasgow grades≤ 5 and is good if Glasgow grades ≥6. There can be cerebral vascular spasm when blood flow rate is quicken, which prognosis is better. The prognosis is best for patiens with spectra eumorphism, blood flow rate normal and no changes of blood flow rate. Conclusions The prognosis evaluation effect of TCD is very important in coma patients.更多还原