床旁经颅多普勒在重症脑血管病监护中的应用

经颅多普勒（transcranial doppler，TCD）的2MHz超声探头可以透过颅骨薄弱部位实时动态监
测颅底Willis环组成的血管血流速度，从而得到脑血流动力学等参数，在重症脑血管病领域得到了广
泛的应用。TCD一直是蛛网膜下腔出血床旁诊断的有力武器，但是TCD诊断的血管痉挛对临床预后的
判断受到临床挑战。血管再通迎来春天，床旁TCD可以对血管再通治疗后高灌注综合征的发生起到
预警作用，而且可以随访检测血管再通的治疗效果。TCD对于无创颅内压监测的指示作用有待国际公
认的可重复的数学模型出现。

Application of Bedside Transcranial Doppler in Monitoring of Severe Cerebrovascular Diseases

Transcranial Doppler (TCD) is a kind of convenient noninvasive ultrasound
equipment. Its 2 MHz ultrasonic probe can pass through the skull weak parts and monitor blood
flow velocity real-timely, so that the cerebral hemodynamic parameters are obtained, which is
applied widely in the field of severe cerebrovascular diseases. TCD is also a useful tool for bedside
diagnosis of subarachnoid hemorrhage. However, TCD diagnosis of vascular spasm for evaluating
clinical prognosis faced some challenge. Now it is the era of endovascular treatment, and the
bedside TCD can be used in early diagnosis of hyperperfusion syndrome after endovascular
recanalization, and can be used to assess the therapeutic effect of vascular recanalization in followup.
The indication function of TCD for non-invasive intracranial pressure monitoring needs an
internationally accepted and repeatable mathematical model.