微血管多普勒在颅内动脉瘤术中的应用

Intraoperative microvascular doppler sonography in aneurysm surgery

目的探讨微血管多普勒这一无创性监测技术在颅内动脉瘤术中应用价值。方法对37例颅内动脉瘤患者应用微血管多普勒的20MHz微探头进行术中监测,记录放置动脉瘤夹前后的动脉瘤、载瘤动脉及主要邻近血管血流动力学变化情况,对血流参数进行分析。结果所有患者均获得术中微血管多普勒监测。根据微血管多普勒比较夹闭前后血流情况显示,有4例动脉瘤夹闭不完全,有7例夹闭后出现邻近血管狭窄,经调整瘤夹位置后平均血流速度基本恢复。术后复查DSA与微血管多普勒显示结果相符合。结论微血管多普勒是一种方便、快捷、可以信赖的术中监测技术,可常规应用于颅内动脉瘤夹闭手术中。

Objective To evaluate the efficacy and reliability of intraoperative microvascular doppler sonography（IMD） for the assessment of cerebral hemodynamics in aneurysm surgery. Methods Among 37 patients who underwent surgery, microvascular Doppler with a 20-MHz probe （ 1-mm diameter） was used before and after clip to confirm the obliteration of aneurysms, the patency of parent vessels and branching arteries. The findings of IMD were analysed. Results Intraoperative microvascular Doppler was applied in all 37 patients. Incomplete obliteration was detected in 4 aneurysms. Vascular stenosis was detected in 7 aneurysms. The clip was adjusted on the basis of the IMD findings and normalized flow velocities were produced upon reinsonation. The findings from intraoperative microvascular doppler sonography correlated well with post-operative angiography in all cases. Conclusions Intraoperative microvascular Doppler is a reliable method and can be routinely used in cerebral aneurysm surgery.