经颅多普勒超声在颅内压增高监测中的临床价值

The Clinical Value of TCD in Diagnosis of High Intracranial Pressure

目的探讨颅内压增高时床旁经颅多普勒超声(TCD)监测的应用价值。方法采用EME COMPANIONⅢ型经颅多普勒超声诊断仪,对32例ICU重症监护患者均于床旁行TCD脑血流动力学检测。结果32例患者首次TCD检测26例(81.3%)分别为尖锐波、振荡波、钉子波、无血流信号及高流速改变;10例动态观察TCD改变,除2例高流速改变转归为正常外,余8例最终为无血流信号。结论TCD特征性的频谱改变与颅内压增高关系密切,可为临床提供早期脑死亡的判定依据,对重症患者的预后评价具有较高临床实用价值。

Objective To explore the the clinical value of bedside transcranial Doppler sonography（TCD）in patients with high intracranial pressure and brain death. Methods 32 cases of patients were detected bedside by EME COMPANION Ⅲ TCD diagnostic apparatus. Results of all the 32 cases, 26 cases（81.3 % ）detected for the first time had the appearance of sharp waves, oscillation waves, nail waves, no blood signal and high rate of flow;of 10 cases detected dynamicly, 2 cases had high rate of flow tumover to normal, other 8 cases had no blood signal in the last. Conclusions Distinctive frequency spectrum change of TCD have high sensibility and specificity to high intracranial pressure and brain death. This detection can give diagnosis evidence to pristine brain death. It also has high clinical practical value to the prognostic evaluation of various kinds of coma patients.