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目的用经颅多普勒超声观察甘露醇对急性期脑出血患者脑血流动力学的影响。方法以大脑中动脉(MCA)和颈内动脉颅外段(EICA)为靶血管,观察30例急性期脑出血患者脑血流变化的趋势及应用甘露醇前后各指标的变化。结果Ⅰ组静滴甘露醇前后MCA和EICA的收缩期峰流速(Vs)、舒张期流速(Vd)、平均流速(Vm)、脉动指数(PI)无明显变化(P>0.05);Ⅱ组用药后MCA的Vd、Vm、Vs增加,PI降低(P<0.05);EICA的Vd增加(P<0.05),Vs、Vm、PI无明显变化(P>0.05)。结论脑损害较轻的患者应用甘露醇可改善脑灌注,甘露醇对严重脑损伤患者难以发挥调节脑血流作用。
Objective To observe the effect of mannitol on cerebral hemodynamics in patients with acute cerebral hemorrhage by transcranial Doppler echocardiography. Methods The cerebral blood flow changes in 30 patients with acute cerebral hemorrhage were observed with the middle cerebral artery (MCA) and the extracranial segment of the internal carotid artery (EICA) as targets. The changes of each index before and after administration of mannitol were observed. Results The peak flow velocity (Vs), diastolic flow velocity (Vd), mean flow velocity (Vm) and pulsatility index (PI) of MCA and EICA in group Ⅰ before and after intravenous infusion of mannitol showed no significant change (P> 0.05) The Vd, Vm and Vs of MCA increased and PI decreased (P <0.05). The Vd of EICA increased (P <0.05) and Vs, Vm and PI had no significant change (P> 0.05). Conclusion Mannitol can improve cerebral perfusion in patients with mild brain damage. Mannitol is difficult to regulate cerebral blood flow in patients with severe brain injury.