经颅多普勒在后循环缺血性眩晕疗效评估中的应用价值

目的探索经颅多普勒技术在后循环缺血性眩晕疗效评估中的临床价值,为后循环缺血性眩晕疾病诊断、治疗提供参考依据。方法收集后循环缺血性眩晕患者86例,给予常规治疗,并根据患者情况加服中药治疗,治疗前后行经颅多普勒检查,比较TCD参数变化情况。结果 64例(74.42%)椎基底动脉的终末支大脑后动脉血流异常以血流速度减慢为主,椎基底动脉和大脑后动脉血流速减慢分别是67.44%和51.16%,少数出现动脉硬化症,分别是40.70%和29.07%。多数患者同时出现颈内动脉血流异常,大脑中动脉和大脑前动脉发生率较为接近,分别为86.04%和86.05%,以血流减慢为主。入选患者治疗后,有效74例,总有效率为86.05%,无效12例。有效与无效病例的各指标进行比较,前者VA和BA的Vs、Vm均较后者显著升高,差异具有统计学意义(P0.05)。结论 TCD具有无创性,可作为后循环缺血性眩晕患者颅底大动脉血流动力学的有效观察指标,显示不同时期病理变化,为后循环缺血性眩晕疾病诊断、治疗提供参考依据。

The applicationvalue of transcranial Doppler in the therapeutic evaluation of vertigo induced by ischemic pos-terior cerebral circulation

Objective To explore the application of transcranial Doppler in the efficacy evaluation of vertigo induced by ischemic posterior circulation ,in order to provide theoretical evidences .Methods The TCD parameters in 86 cases with verti‐go induced by ischemic posterior circulation in our hospital from September 2013 to September 2014 who were treated by con‐ventional treatment and Chinese herbs if necessary were recorded .Results 64 cases (74.42% ) with the abnormalities of pos‐terior cerebral artery which was the terminal branch of vertebral basilar artery mainly presented slowing velocity of blood flow . And the decreasing velocity of basilar artery and posterior cerebral artery accounted for 67.44% and 51.16% ,respectively , which separately accounted for 40.70% and 29.07% in a few patients with arterial sclerosis .At the same time ,abnormality of internal carotid artery also occurred in most patients ,and the incidence of abnormality that mainly manifested slowing velocity of blood flow was 86.04% in middle cerebral artery ,similar to 86.05% in anterior cerebral artery .After treatment ,of the se‐lected 86 patients ,74 cases who had favorable therapeutic efficacy with the total effective rate of 86.05% ,showed the higher levels of Vs and Vm of both VA and VB than 12 cases who were in vain (P<0 .05) .Conclusion TCD has the property of no invasion and shows the pathological changes in different times ,which can be regarded as effectively observation index in pa‐tients with vertigo induced by ischemic posterior cerebral circulation in order to provide theoretical evidences for the diagnosis and treatment .