脑动脉瘤破裂出血的多普勒超声研究

Study on the Hemorrhage After Cerebral Aneurymal Rupture by Doppler Ultrasound

应用多普勒超声研究１３例经脑血管造影证实的脑动脉瘤破裂出血患者脑循环动态改变。１０例出现不同程度的血管痉挛，以出血侧大脑中动脉为主，８～１４天达高峰，此１０例均行手术夹闭动脉瘤，术前１～３天血流速度在８４～１３０ｃｍ／ｓ，预后好，余３例表现为严重颅内压升高和脑部低灌注的患者未手术死亡。表明多普勒超声能及时发现血管痉挛并动态观察，同时反映颅内压和脑灌注的变化，对选择手术时机和判断临床预后有重要意义。

The Doppler ultrasound were used to study the serial changes of cerebral circulation in13 patients with hemorrhage after aneurysmal rupture. A marked increase of the now velocity of middlecerebral artery was found in ten patients operated,and eight-fiften days after onset the velocity reachedpeak value of about 200cm/s and then declined.1-3 days before operation the meam flow velocity was84 -130cm/s,there had good progmosis.Increased intrecranial pressure and cerebral bypoperfusionwere observed in three patients by Doppler ultrasound,the died in two weeks. The results indicate thatthe Doppler ulrtasound is a reliable and convenient noninvasive method for monitoring the change ofcerebral vasospasm, intracranial pressure and cerebral blood perfusion, which provides important clinical informations concerning choice of the time of operation and evaluation of clinical prognosis.