手术中微血管多普勒超声在颅内巨大动脉瘤治疗中的应用

目的探讨手术中微血管多普勒超声在颅内巨大动脉瘤手术治疗中的应用。方法13例颅内巨大动脉瘤患者进行了手术直接夹闭或动脉瘤孤立+旁路移植手术。术中分别在动脉瘤夹闭前及夹闭后应用术中微血管多普勒对动脉瘤及邻近血管进行血流速度的检测,以及在动脉瘤孤立后进行移植血管和吻合血管血流的检测。结果巨大动脉瘤内血流的多普勒波谱主要表现为4种:无波形;间断不连续波形;双向波形;单向波形,但速度均小于载瘤动脉的速度。5例直接塑形夹闭动脉瘤中,其中2例在夹闭后证实有载瘤动脉或邻近血管的狭窄。7例旁路移植手术中,多普勒检测移植血管均通畅。1例单纯孤立术夹闭后检测瘤内无血流。结论在颅内巨大动脉瘤的手术治疗中,术中微血管多普勒超声是一种简便、安全有效的监测技术。

Application of intraoperative microvascular Doppler ultrasonography in intracranial giant aneurysm surgery

Objective To study the application of intraoperative microvascular Doppler ultrasonography in intracranial giant aneurysm surgery.Methods Thirteen patients with intracranial giant aneurysm were treated with clipping the aneurysm or trapping and bypass surgery.Microvascular Doppler ultrasonography was conducted to examine the blood flow velocity in the aneurysmal sac and in the adjacent vessels before and after aneurysm clipping,or to examine the blood flow velocity and direction in the graft vessels after trapping and bypass surgery.Results There were four kinds of Doppler wave forms in giant aneurysms:no wave form,interrupted wave form,two direction wave form,one direction wave form.The microvascular Doppler ultrasonography showed the stenosis in the parent artery or the adjacent vessels after clipping in 2 patients.In the patients undergoing trapping and bypass surgery,all graft vessels were confirmed to be patent by microvascular Doppler ultrasonography.Conclusions The microvascular Doppler ultrasonography is a feasible,safe,and very reliable technigue in giant aneurysm sugery.