经颅多普勒超声动态监测重型颅脑损伤后脑血流动力学变化的临床意义

目的 探讨经颅多普勒超声（ＴＣＤ）动态监测重型颅脑损伤后脑血流动力学变化的临床意义。方法 ６０例重型颅脑损伤患者为观察组，２５名健康体检者为对照组，于重型颅脑损伤后３天、７天、１０天、１４天动态监测ＴＣＤ大脑中动脉（ＭＣＡ）收缩期峰血流速度（Ｖｓ）、平均血流速度（Ｖｍ）和脉动指数（ＰＩ）的变化。结果 重型颅脑损伤后３天，ＭＣＡ－Ｖｍ已明显下降，与对照组相比有明显差异（Ｐ〈０．０５）。ＭＣＡ－Ｖｓ，

Clinical significance of cerebral blood flow dynamics changes by transcranial Doppler serial monitor after severe head injuries

Objective To establish the clinical significance of cerebral blood flow dynamics for Transcrani- al Doppler(TCD) serial monitor after severe head injuries.Methods The study group was consisted of 60 patients of se- vere head injuries and the control group was consisted of 25 healthy persons for the general health examination.TCD serial monitor changes of MCA-Vs,MCA-Vm,MCA-PI values corresponding in 3,7, 10, and 14 days after severe head inju- ries were monitored.Results FOr the study group,the level of MCA-Vm values descended 3 day after severe head injuries compared with the control one, showing statistic significant diffence(P < 0.05). The level Of MCA-Vm MCA-Vs values in the study group was the lowest 10 days after injuries compared with that of 3 days after injuries,showing statistic significant difference(P < 0.05 - 0.01),and then returned normal gradually .At the same time,the level Of MCA-PI values had raised in 3 days(P < 0.01 ),was the highest in 7 days(P < 0.05) ,and then lowered. gradually. It showed that abnormal changes. of cerebral blood flow dynamics would occurr in 3 days after severe head injuries;which reached its peak in 7 - 10 days. Conclusion Not only can we know the changes of cerbral blood flow dynamic,but also we can evaluate intracranial pres- sures(ZCP)and cerebral perfusion pressures(CPP)by TCD serial monitor after severe head injuries.