脑积水患者行经颅多普勒检测的意义

目的明确脑积水患者经颅多普勒（TCD）监测结果与颅内压的关系。方法选择我院32例行脑室腹腔分流术的脑积水患者（观察组），分别于术前1d和术后5d行大脑中动脉（MCA）的TCD监测；另选择27名门诊体检健康个体为对照组，行大脑中动脉TCD监测，并与观察组作对照。结果观察组患者行分流手术前TCD监测显示MCA收缩期血流速度（Vs）、舒张期血流速度（Vd）以及平均血流速度（Vm）较对照组明显下降（P〈0．05）；而搏动指数H和阻抗指数砌却明显高于对照组（P〈0．01）。观察组患者治疗前、后MCA的PI、RI、Vd、Vm间差异有显著性意义（P〈0．05）。结论经颅多普勒中RI和PI值可作为评价脑积水患者颅内高压的有效手段。

The Usage of Transcranial Doppler in Patients with Hydrocephalus

Objective To investigate a possible relationship between Transcranial Doppler (TCD) parameters and intracranial pressure (ICP) changes in adult patients with hypertensive hydrocephalus.Methods Blood flow velocity in the middle cerebral artery (MCA) was studied by TCD in 32 hydrocephalus patients 1 day before shunting and 5 days after operations,and 27 healthy controls were taken in as reference.ICP was measured in the patient group before ventricular shunting and was correlated with TCD data.Results The mean cerebral blood flow velocity (CBFV) in hydrocephalic patients prior to ventriculoperitoneal shunting was significantly lower than in the control group(P<0.05).Compared to normal persons,systolic and end-diastolic CBFV values in patients were significantly decreased.Pulsatility index (PI) and resistant index (RI) values in patients with elevated ICP prior to shunting were significantly increased in comparison to those of normal persons(P<0.01).Immediately after shunting,ICP returned to normal,and PI and RI values decreased significantly,while the mean CBFV increased(P<0.05).Conclusion TCD may provide a tool for assessment of ICP in adult patients with occlusive hydrocephalus.Changes in the RI and PI indices appear to be useful indicators of elevated ICP.