连续经颅多普勒在急性脑梗死中的诊断价值研究

目的观察连续经颅多普勒超声（TCD）在急性脑梗死中的诊断价值。方法对我院47例急性脑梗死发作小于24h的患者进行连续TCD检查，时间点分别为发病后24h、24～48h、4～8d，选取同期年龄相似的21例健康人对照。结果首次TCD检查中17例患者脑血流结果正常，10例大脑中动脉（MCA）血流减少，7例MCA流速增加，2例大脑后动脉无血流，11例MCA流速减慢，而通过连续不同时间的第2、3次TCD检查，进一步提供了这些患者的脑血流变化信息。结论连续TCD可以揭示脑梗死前后脑血流的动态变化。对脑梗死的诊断、治疗和愈合判断都有重要的指导价值。

Clinical diagnosis study of transcranial Doppler sonography in acute ischemic stroke disease

Objective To evaluate the effect of transcranial Doppler(TCD) on detecting acute ischemic stroke.Methods Forty-seven patients with acute ischemic hemispheric stroke within 24 hours were examined.TCD was performed within 24 hours,from 24 to 48 hours,and 4 to 8 days after ictus.Norms for TCD examination were determined in an age-matched control group that included 21 subjects without cerebrovascular disease.Results Initial TCD study showed in 17 stroke patients,the results of examination were normal,in 10 patients,the flow of MCA(middle cerebral artery) decreased,in 7 patients the flow velocities of MCA increased.In two patients,the initial TCD examination showed no flow in ipsilateral PCA associated with increased MCA velocity on the symptomatic side and a decreased blood flow velocities in MCA on the symptomatic side in 11 patients.Serial 2nd and 3rd TCD of different time demonstrated different patterns of collateralization and suggested dynamic collateralization patterns after stroke.Conclusion TCD is worth in detecting the ischemic hemispheric stroke because if may reveal dynamic changes in cerebral circulation before and after acute stroke.