经颅多普勒超声在颅内感染患儿中的应用

目的应用经颅多普勒超声(TCD)观察颅内感染患儿脑血流动力学的变化情况,并了解脑血流动力学与颅内压之间的联系。方法以大脑中动脉(MCA)为靶血管,观察颅内感染组及对照组患儿脑血流动力学情况;腰穿或应用甘露醇前后各指标的变化。结果颅内感染组Vp、Vm、PI、RI明显高于对照组;患儿在腰穿前大脑中动脉Vp、Vm、PI、RI均高于腰穿后;使用甘露醇后大脑中动脉Vp、Vm、PI、RI均低于使用甘露醇前。结论颅内感染患儿脑血流动力学多异于正常,脑血流动力参数可因颅内压而变,TCD可反映颅内脑血流灌注情况;因此TCD有助于判断颅内感染患儿病情、指导临床治疗和评估预后。

Application of Transcranial Doppler Ultrasonography in Children with Intracranial Infection

Objective To observe the changes of cerebral blood flow velocity in children with imracranial infection by transcranial Doppler （TCD）, and to study the correlation between cerebral hernodynamics and intracranial pressure. Methods The blood flow velocity changes of the right middle cerebral artery （MCA） were monitored by TCD in 64 children patients. All patients were divided into intracranial infection group （n= 34） and control group （n= 30）. Peak velocity （Vp）, diastolic ve- locity （Vd）, mean velocity （Vm）, resistant index （RI） and pulsatility index （PI） of MCA were monitored before and after lum- bar puncture or mannitol bolus administration. Results Vp, Vm, PI and RI of MCA in the intracranial infection group were significantly higher than those in the control group. Vp, Vm, RI and PI of MCA in the intracranial infection group before lumbar puncture were all higher than those after. Vp, Vm, RI and PI of MCA in the intracranial infection group after mannitol bolus administration were all lower than those before. Conclusions The cerebral blood flow velocity is abnormal in most intracranial infection children patients. The results of TCD ultrasound may reflex cerebral blood perfusion and the changes of intracranial pres- sure, therefore, TCD is helpful to the judge of the patient＇s condition, the guidance of the treatment and the prediction of the prognosis.