脑动静脉畸形手术前后局部脑皮质血流的变化

为观察脑动静脉畸形手术前后局部脑皮质血流量 (CBF)的变化 ,对 63例成年脑血管畸形病人 :2 5例巨大脑血管畸形 (血管畸形直径≥ 6cm) ,3 8例小血管畸形 (血管畸形直径 <6cm)进行研究。用激光多普勒血流仪 (LDF)分别记录血管畸形切除前后及术后 2 4h脑血流数值 ,比较脑血流变化情况。发现 :巨大血管畸形切除后脑血流比切除前明显增加 ,直到术后 2 4h仍然保持在高水平 ;而小血管畸形切除后脑血流无显著变化。提示 :巨大血管畸形和小血管畸形在切除前后的脑血流变化是不同的 ,监测脑血管畸形切除后脑血流变化有助于减少巨大血管畸形的出血等并发症。

Changes of Regional Cerebral Blood Flow after Resection of Cerebral Arteriovenous Malformation

The aim was to investigate pre-and postoperative change of regional cerebral cortical blood flow in patients with cerebral arteriovenous malformation (AVM). Sixty-three adult patients with AVM were entered into this study at Beijing TianTan Hospital from September 2001 to May 2003. One group had 25 patients who had giant cerebral AVM (diameter more than 6 cm) and the other group had 38 patients who had small AVM (diameter less than 6 cm). Pre and post AVM resections Cortical blood flow(CBF) were measured by laser Doppler flowmeter(LDF), Post-operatively, the probe of LDF was implanted adjacent to the area of the AVM for 24 h and the CBF was recorded. The CBF in the giant group increased obviously, and still remained at high level till 24 h after resection. In small AVM group, the CBF had no obvious change. The change of the CBF in giant and small AVM during the operation is different. Monitoring the CBF is helpful to understand preand postoperative change of cerebral cortical blood flow in patients with cerebral arteriovenous malformation.