高压氧进出舱前后脑底动脉血流动力学的三维经颅多普勒检测

The Detection of the Cerebral Arterial Hemodynamics Using 3D-TCD Before And Cabin of HBO

为探明高压氧对脑底动脉血流动力学的作用机制,本文应用三维经颅多普勒仪(3D-TCD)对患有各种不同类型脑病的43例高压氧治疗(第Ⅰ组)及正常健康对照组(第Ⅱ组)36例分别于入舱前、及出舱后30分钟,1h、2h检测ACA、MCA及PCA血流速度。结果:第Ⅰ组,36/43例(83.7%)于出舱后脑底动脉血流速度明显加快,其中出舱后30分钟血流速度加快者有22例,一小时开始加快者有8例,6例于二小时才开始加快,5例无变化,2例减低。无1例于1小时恢复正常,仅有13例于二小时恢复正常。血流流变学进出舱前后无明显改变,甲皱微循环以流态改变为著,尤以出舱后一小时加快最明显,形态及袢周变化不明显。第Ⅱ组36例中,脑底动脉血流速度均于出舱后30分钟明显加快,持续一小时恢复至入舱前状态。本研究表明正常健康人与脑部疾病患者不仅对高压氧的反应不同,而且在恢复至入舱前状态上也有明显差别,作者认为这可能就是高压氧对脑部疾病的一种治疗效应。本研究还表明高压氧进出舱前后脑血流速度的加快与血流流变学无明显关系,而是由于血管收缩、血管阻力增加所致。

In order to detect the effection of HBO treatment to cerebral arterial hemodynamics, the blood flow velocities of ACA. MCA, PCA in 43 patients with many kinds of brain diseases (group 1)treated by HBO and 36 normal healthy persons (group 2 as contrasts) were examined before enteringthe cabin and 30 minutes,one hour and two hours after coming out from cabin respectively using 3D -TCD. The results were:in group 2, cerebral arterial blood flow velocties in 36/43 cases (83. 7%) accelerated obviosly after the cabin, among them, 22 cases quickened within 30 minutes,8 cases after one hour, and none of them rcovered to normal level within one hour, 13/36 cases returned to normal level within two hour,6/43 cases (14. 0%) speeded up at two hours. 5 cases had no change,two cases low-ered. There were no distinct changes in blood rheology before and after the cabin. As concerning to the nail fold microcirculation, there were obvious changes in blood flow velocity.especialy in one hour after the cabin,but there were no changes in shaoe or circum - loop, In group 2,the cerebral arterial blood flow velocities of all the 36 cases quickened obviously within 30 minutes after the cabin and continued to one hour,then they returned to normal.This research demonstrated that there were not only different reactions to HBO,but also distinct difference in returing to the flow velocity before entering the cabin between brain deseased patients and healthy controls, the authour considered that this may be the therapeutic effect of HBO to those who had cerebral diseases. This research also indicated that quickened blood flow velocity had no relation to blood rheology,it was due to vascular contraction and increased resistance.