经颅多普勒对蛛网膜下腔出血后脑血管痉挛的诊断价值

The diagnostic value of cerebral vasospasm in subarachnoid using transcranial Doppler

目的探讨经颅多普勒超声(TCD)检测重型脑外伤病人蛛网膜下腔出血(SAH)致脑血管痉挛(CVS)的血流动力学变化。方法对60例重型脑外伤病人,于第1、3、5、7、10天不同的时间进行TCD检测,对CVS组与非CVS组进行对照分析。结果重度脑外伤后,CVS组大脑中动脉(MCA)血流速度伤后即进行性升高,3至5d达高峰,随后逐渐回落,但仍明显高于正常值;而非CVS组MCA血流速度伤后3d维持在正常范围,伤后5d略有升高,随后回落逐渐接近正常,与CVS组比较差异有统计学意义(P<0.05)。结论TCD检测能无创实时评价SAH后CVS的动态血流速度变化,对CVS的预防和治疗出血性脑损害的评估有一定意义。

Objective To explore the use of TCD ultrasound to examine the rhombencephalon SAH after severe traumatic brain injury （TBI） altered hemodynamics. Method TCD was used to check 60 cases of severe TBI patients on days 1,3, 5, 7 and 10 post - injury at various times. Then compared and analyzed the CVS and non - CVS. Results In the severe TBI CVS group, the progressive rising of the blood flow velocity in the middle cerebral artery （MCA） after injury reached its peak at 3 -5 days, and then gradually fell back down, but was still clearly exceeding normal levels. In the non - CVS group, the MCA remained in the normal range for 3 days post - injury, after 5 days blood flow velocity increased slightly and then gradually fell back to near normal. Compared with CVS group, the difference was statistically significant （P 〈 0.05）. Conclusion TCD can non - invasively evaluate the CVS blood flow velocity change after SAH, and also make sense to evaluate the prevention of CVS as well as treat Traumatic Brain Injury.