颅骨修补术对颅骨缺损患者脑血流动力学的影响(附12例报道)

Effect of cranioplasty on cerebral haemodynamics of patients with skull defect(report of 12 cases)

目的探讨颅骨修补术对颅骨缺损患者脑血流动力学和神经症状的影响。方法颅骨修补术前、术后第7天分别行经颅多普勒(TCD)测定双侧颈内动脉颅外段(eICA)及大脑中动脉(MCA)在卧位与坐位时的脑血流速度,行手术前后自身对照分析,术后半年随访了解神经症状情况。结果颅骨修补术后患者于坐位时的脑血流速度明显改善,而对卧位时的血流速度改变不明显;术后半年神经症状消失或得到明显改善。结论颅骨修补术后可改善脑血管的调节功能,进而有利于神经功能的恢复。

Objective To investigate the effect ofcranioplasty on cerebral haemodynamics and neurological symptoms of patients with skull defect. Methods The blood flow velocities in the middle cerebral artery （MCA） and extracranial internal carotid artery （eICA） were measured with transcranial Doppler （TCD） before and 7 d after cranioplasty at supine and sitting positions, respectively. The pre-operative and post-operative blood flow velocities were analyzed by own cross-check analysis. Neurological symptoms of patients were monitored during the follow-up for 6 months. Results The blood flow velocity at sitting position was improved significantly, but the one at supine position did not change obviously; neurological symptoms of patients were improved or disappeared completely. Conclusion Cranioplasty could improve the regulating function of cerebral vessels and benefit the restoration of nerve function.