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目的 :探讨经颅多普勒超声在脑动脉瘤手术前、后的应用价值。方法 :采用经颅多普勒超声对 35例脑动脉瘤破裂的蛛网膜下腔出血患者进行手术前后不同时间动态监测 ,记录颅内外各动脉的血流速度 ,计算大脑中动脉 (MCA)与颈内动脉 (ICA)颅外段平均血流速度的比值。结果 :1 7例 (4 8.5 7%)出现脑血管痉挛 ,其中 1 6例有单侧或双侧 MCA痉挛 ;术后 7天内脑血管痉挛发生率最高。VMCA/ VICA的比值无血管痉挛组为 1 .80± 0 .1 4 ;比值 >3均有脑血管痉挛 ;比值 >6提示预后较差。结论 :经颅多普勒超声对蛛网膜下腔出血患者手术前后动态监测 ,可以了解脑血管痉挛发生、发展的全过程 ;指导临床治疗 ;判断手术时机和评估预后
Objective: To investigate the value of transcranial Doppler ultrasound before and after cerebral aneurysm surgery. Methods: Transcranial Doppler echocardiography was performed on 35 patients with subarachnoid hemorrhage ruptured by cerebral aneurysm at different time before and after surgery. The intracranial and extracranial arterial blood flow velocity was recorded. The mean arterial pressure Internal Artery (ICA) extracranial segment average blood flow velocity ratio. Results: Cerebral vasospasm was found in 17 (4 8.57%) patients, of which 16 had unilateral or bilateral MCA spasm. The incidence of cerebral vasospasm was highest within 7 days after operation. VMCA / VICA ratio of vasospasm group was 1.80 ± 0.14; ratio> 3 have cerebral vasospasm; ratio> 6, the prognosis is poor. Conclusion: Transcranial Doppler ultrasound in patients with subarachnoid hemorrhage before and after the dynamic monitoring of surgery, we can understand the occurrence and development of cerebral vasospasm the whole process; to guide clinical treatment; to determine the timing of surgery and assess the prognosis