经颅多普勒对脑血管痉挛的应用价值

Application evaluation of transcranial Dopple to cerebral angio spasm

目的:通过应用经颅多普勒(TCD)检测蛛网膜下腔出血或重度颅脑损伤的急性期患者的颅内血流状况,判断脑血管痉挛(CVS)的存在,从而推测脑缺血障碍的程度。方法:应用经颅多普勒检测2000～2005年已经明确诊断为蛛网膜下腔出血或重度颅脑损伤的患者47例,与60例正常体检且颞窗良好者进行对照。结果:患病组大脑中动脉(MCA)的收缩期峰值流速(Vs)、舒张期末流速(Vd)和平均血流速度(Vm)不同程度加快,部分严重痉挛的患者,颈内动脉颅外段峰值流速相对减低,大脑中动脉与颈内动脉颅外段血流速度比值(VMCA/VICA)明显增加,提示有脑血管痉挛的存在,痉挛越重,脑缺血越重。结论:蛛网膜下腔出血或重度颅脑损伤的患者发生痉挛的机率明显大于正常体检人群(P<0.01),具有统计学意义。

Objective： The purpose of this paper is to provide a method to speculate the degree of brain ischemia by applying transcranial Doppler. Which tests the patients condition of blood that is flowing in the brain as their subarachnoids bleeding. So as to estimate the existence of cranial arterial vasospasm. Methods： In order to improve the efficiency of the method or make it more intuitionally ,The following approach may be applied.People were divided into two groups and compared by transcranial Doppler. 47 cases who were subarachnoid hemorrhage that have been definite diaggnosed or serious injured of their brains in the year from 2000 to 2005 were compared with 60 cases who were heathy in medical examinations and the Temporal Bone window were well too. Results：Datas were noticeable, the first group＇s constrictive peak velocity, diastole end of diaseolie velocity and average blood stream speed of middle cerebral artery were faster with different degree. And that some patients with serious spasm whose internalcaro-tid artery blood flowed decreasingly, and the velocity ratio of VMCA/VICA was increasing, that is to say cranial arterial vasospasm exists. And the more constrietive. the worse brain ischemia. Conclusion：There are significant difference between patients with subarachnoid hemorrhage or severe eraniocerebral injury and the normal group about the probability of cerebrovascular spasm （P〈0.01）, the difference has statistical significance.