经颅多普勒对脑外伤后脑血管痉挛的诊疗评估

Evaluating Transcranial Doppler of Diagnosis and Treatment on Cerebral Angiospasm in Craniocerebral Injury

目的:探讨经颅多普勒(TCD)对脑外伤患者脑血管痉挛(CV S)的诊疗价值。方法:对95例颅脑外伤病人进行动态TCD检查,并结合患者GCS评分、蛛网膜下腔出血量(t-SAH)的大小对其结果进行统计评价。结果:TCD检查结果与GCS评分和、t-SAH量的大小相关,并与脑血管痉挛(CV S)的发展相一致,常在伤后1 d^3 d开始出现,3 d^7 d达高峰,2周后渐减轻。大脑中动脉平均血流速度(VM CA)>200 cm/s或VM CA<45 cm/s者预后差。结论:TCD检查是外伤后CV S动态监测的安全有效的方法,对临床医生判断病情、预后提供依据并指导治疗。

Objective To explore the value of transcranial Doppler （TCD）examination of diagnosis and treatment on cerebral angiospasm （CVS） in patients after craniocerebral injury. Methods 95 cases of craniocerebral injury were dynamic examined by TCD, to evaluating statistical TCD examination result according to patient＇s （;CS grade and amount of traumatic subarachnoid hemorrhage （t-SAH）. Results TCD examination result is correlation to GCS grade and amount of traumatic subarachnoid,and consistent with the development of CVS, CVS occurred at days 1 - 3, reached the peak at days 3-7,andrelieved at 2 weeks later after injury. The spatients which cerebral blood tow velocities of middle cerebral atery（VMCA） more than 180 cm/s or less than 45 cm/s would be get poor prognosis. Conclusions TCD is asafe and effective technique in dynamic inspect CVS after injury,and it could provide evidence of estimating the patient＇s state of illness and prognosis,and guide us how to treat CVS.