经颅多普勒超声在重度颅脑损伤中的临床应用

目的 探讨经颅多普勒超声（transcranial Doppler，TCD）在重度颅脑损伤中的临床应用效果。方法 选取2018年2月至2023年3月于宿迁市第一人民医院行开颅去骨瓣手术治疗的45例重度颅脑损伤患者，所有患者均进行CT和TCD检查，分析Helsinki CT评分与TCD参数的相关性。其中进行颅内压监测的37例患者根据颅内压水平不同，将其分为颅内压正常组（n=3）、颅内压轻度升高组（n=14）、颅内压中度升高组（n=11）、颅内压重度升高组（n=9），比较四组患者的TCD参数。结果 Helsinki CT评分与搏动指数（pulsatility index，PI）、阻力指数（resistance index，RI）均呈正相关（r=0.91、0.89，Ｐ<0.01），与舒张期末血流速度（end of diastolic velocity，Vd）呈负相关（r=–0.92，Ｐ<0.01），Helsinki CT评分与收缩期峰值血流速度（systolic peak velocity，Vs）无相关性（r=–0.39，Ｐ=0.08）；不同颅内压患者的PI、Vd、RI比较差异均有统计学意义（P<0.05）；不同颅内压患者的Vs比较差异无统计学意义（P>0.05）。结论 TCD能较好地反映患者的病情，可对病情恶化起到预警作用，临床应用价值较高。

Clinical application of transcranial Doppler in severe craniocerebral injury

Objective To investigate the clinical effect of transcranial Doppler (TCD) in severe craniocerebral injury. Methods A total of 45 patients with severe craniocerebral injury who underwent decompression surgery for the bone flap were selected from February 2018 to March 2023 in Suqian First Hospital. CT and TCD examinations were performed in all patients, and the correlation between Helsinki CT score and TCD parameters was analyzed. Among them, 37 patients who underwent intracranial pressure (ICP) monitoring were divided into normal ICP group (n=3), mildly elevated ICP group (n=14), moderately elevated ICP group (n=11) and severely elevated ICP group (n=9) according to different ICP levels. TCD parameters of the four groups were compared. Results Helsinki CT score was positively correlated with pulsatility index (PI) and resistance index (RI) (r=0. 91, 0.89, P<0.01), and was negatively correlated with the end of diastolic velocity (Vd) (r=–0.92, P<0.01). Helsinki CT score was not correlated with systolic peak velocity (Vs) (r=–0.39, P=0.08). There were significant differences in PI, Vd and RI among patients with different ICP (P<0.05). There was no significant difference in Vs among patients with different ICP (P>0.05). Conclusion TCD can better reflect the patient’s condition, can play an early warning role in the deterioration of the disease, and has high clinical application value.