微血管多普勒超声在颅内动脉瘤夹闭术中的应用

目的 评价微血管多普勒超声(MDU)技术在颅内动脉瘤夹闭术中的应用.方法 回顾性分析32例开颅夹闭术治疗颅内动脉瘤病人的临床资料,均在动脉瘤夹闭前后行MDU监测载瘤动脉及穿支血管.并评价术中MDU的监测作用.结果 术中MDU监测提示:载瘤动脉闭塞3例,载瘤动脉狭窄6例,调整动脉瘤夹或局部应用罂粟碱湿敷后,MDU监测均恢复正常；其他病人MDU监测均正常.无监测相关并发症发生.所有病人随访3～26个月,术中MDU监测正常,但术后出现栓子脱落至脑梗死1例；其他病人术后均恢复良好.结论 术中MDU监测具有操作简便、结果可靠、无并发症等优点,能降低动脉瘤夹闭术中载瘤动脉及穿支动脉闭塞和狭窄的发生率.

Application of microvascular Doppler ultrasonography during surgery for intracranial aneurysm clipping

Objective To evaluate the application of microvascular Doppler ultrasonography （MDU） during the surgery for intraeranial aneurysm clipping. Methods Clinical data of 32 patients with intracranial aneurysm undergoing aneurysm clipping were analyzed retrospectively. The parent and branching arteries were detected by MDU before and after aneurysm clipping. And the role of intraoperative MDU monitoring was evaluated. Results Intraoperative MDU monitoring showed that parent artery occlusion occurred in 3 cases and stenosis in 6, which returned to normal after adjustment of the clip or topical wet dressing with papaverine. The findings by MDU monitoring were always normal in other patients, and no complication associated with monitoring occurred. All the patients were followed up for 3 to 26 months, MDU findings were normal during the operation but cerebral infarction caused by an exfoliative embolus after the operation occurred in 1 patient, while other patients achieved good recovery postoperatively. Conclusions Intmoperative MDU monitoring has advantages as convenient operation, reliable outcome and no complication, can reduce the incidence rate of parent and branching artery occlusion and stenosis during the aneurysm clipping.