经颅多普勒超声在自发性脑出血预后判断中的应用

The application of transcranial Doppler in predicting prognosis of patient with spontaneous intracerebral hemorrhage

目的 研究经颅多普勒超声 (TCD)在自发性脑出血预后的评价及脑死亡诊断中的价值。方法 使用EME TCD仪 ,动态监测 68例Glasgow评分≤ 7分的自发性脑出血昏迷患者的双侧大脑中动脉的血流速度、频谱形态、脉动指数等。结果 其中脑死亡组 2 8例 ,颅内压增高组 40例 ,前者双侧大脑中动脉呈全舒张期反向血流或针尖状收缩峰血流 ,持续 1h以上无恢复 ,是预示脑死亡较可靠的指标。两侧大脑中动脉血流不对称与局限性脑损伤有关。结论 TCD对评估自发性脑出血预后 。

Objective To investigate the value of transcranial Doppler(TCD)in the prediction of the outcome and determination of brain death in patient with spontaneous intracerebral hemorrhage. Methods The waveforms and the cerebral blood flow velocities of the bilateral middle cerebral arteries(MCA)were monitored and analyzed using EME TCD in 68 comatose patients with Glasgow scores ≤7. Results The results showed that persistence of retrograde diastolic flow or small systolic forward flow in bilateral MCA lasted for more than 1 hours were observed in 28 cases of comatose patients, which was a reliable indicator for predicting or confirming brain death. Asymmetrical TCD waveforms were characteristically associated with the localized brain damage. Conclusion TCD monitoring is a useful technique for predicting outcome and guiding treatment of patient with spontaneous intracerebral hemorrhage.