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目的:探讨经颅多普勒超声(TCD)对于诊断锁骨下动脉盗血综合征(SSS)的临床意义及可靠性。方法:回顾性总结2007～2008年我院TCD室诊断的18例SSS患者,结合其临床症状及TCD表现对其结果进行分析。结果:18例患者中8例表现为后循环缺血症状,4例表现为患侧上肢缺血症状;16例收缩压差≥20mmHg,1例舒张压差≥20mmHg;左侧锁骨下动脉(SubA)病变10例,右侧SubA病变8例;Ⅰ期盗血6例,Ⅱ期盗血9例,Ⅲ期盗血3例;所有病例均行CTA检查证实有SubA闭塞性病变,1例经DSA证实,并行支架置入治疗,后期随访,盗血消失。结论:TCD是诊断SSS及其盗血程度、途径敏感可靠的方法,可作为SSS的首选筛查方法及长期随访工具。
Objective: To investigate the clinical significance and reliability of transcranial Doppler ultrasound (TCD) in the diagnosis of subclavian steal syndrome (SSS). Methods: 18 cases of SSS diagnosed in our hospital from 2007 to 2008 were retrospectively reviewed. Their clinical symptoms and TCD findings were analyzed. Results: Among the 18 patients, 8 cases showed symptoms of posterior circulation ischemia, 4 cases showed symptoms of ipsilateral upper limb ischemia, 16 cases of systolic pressure difference of 20 mmHg, 1 case of diastolic pressure difference of 20 mmHg, left subclavian artery (SubA) 10 cases of lesions, 8 cases of SubA lesions on the right side; 6 cases of stage Ⅰ steal, 9 cases of stage Ⅱ steal, 3 cases of stage 3 steal; CTA examination confirmed SubA occlusive disease in all cases, and 1 case confirmed by DSA , Parallel stenting into the treatment, follow-up, steal disappeared. Conclusion: TCD is a sensitive and reliable method for the diagnosis of SSS and its steal degree, and can be used as the screening method and the long-term follow-up tool for SSS.