经颅多普勒在脑外伤中的应用

目的探讨经颅多普勒 (TCD)在早期发现急性颅脑外伤病人脑血管痉挛中的临床应用。方法对45例急性脑外伤病人的脑血流进行TCD动态监测 ,结合是否伴有蛛网膜下腔出血 (SAH)及脑血管痉挛 (CVS)对结果进行统计评估。结果TCD结果与临床分型密切相关。急性颅脑外伤病人早期大脑中动脉流速 (Vm/MCA)<120cm/s者提示预后良好 ;>140cm/s或<40cm/s者,预后极差。合并SAH者 ,CVS及脑梗塞发生均高于无SAH者。结论急性脑外伤病人的早期脑动脉血流速度与病人的并发症及预后相关。TCD是无创、安全的动态监测手段 ,能为神经外科医生提供有效的指导

The appliance of Transcranial Ultrasound Doppler to patients with acute head injury

Objective To discuss the appliance of TCD (Trans-cranial Doppler) to find inter_cranial vasospasm in earlier period of patients with acute head injury. Methods To monitor cerebral vessels blood flow speed in 45 cases with acute head injury using TCD, compare the results by if the patient complicated SAH (subarachnoid hemorrhage) and CVS (cerebral vessels spasm). Results The results of TCD test were closely correlated to clinic classification of patients. In the earlier period of acute head injury, if the blood flow speed of middle cerebral artery (Vm/MCA) was below 120cm/s, that implied good prognosis, but if it was above 140cm/s or below40cm/s, implied severely prognosis. The patients complicated with SAH had higher incidence of CVS and cerebral infarction than those without SAH. Conclusion The artery blood flow speed in earlier period of acute head injury is correlated to the incidence of complication and the prognosis of patients. TCD is a safe way of monitoring inter_cranial arteries to offer an operative guide to neurosurgeon.