蛛网膜下腔出血后的TCD动态观察

目的:研究蛛网膜下腔出血(SAH)迟发性缺血性神经功能障碍(DIND)患者的经颅多普勒(TCD)动态改变。方法:应用TCD动态检查23例SAHDIND患者,根据DIND侧大脑中动脉(MCA)平均血流速度(Vm)的改变分为流速增高组与流速正常组进行比较。结果:流速增高组DIND侧MCA的Vm与PI呈进行性增高并高于对侧,且早于DIND临床症状出现(P<0.01);流速正常组DIND侧MCA的PI进行性增高并高于对侧,同时Vm进行性减慢并低于对侧,且早于DIND临床症状出现(P<0.01)。结论:SAH迟发性脑血管痉挛(DCVS)发生于脑底动脉和其远端小动脉的TCD表现不同,两者的变化均早于临床症状出现。

THE DYNAMICAL OBSERVATION OF TRANSCRANIAL DOPPLER (TCD) AFTER SUBARACHNOID HEMORRHAGE(SAH)

Objectives:To explore the dynamical change of TCD of DIND after SAH.Methods:23 cases with DIND after SAH were examined by TCD.Depending on mean velocity of blood flow(Vm),patients were divided into two groups Vm was increasing group and normal group.Results:The ipsllateral Vm and Pulsation index(PI)of DIND increased progreeively in increase group than contralateral that and showed that them were early than the clinical symptoms(P<0.01).In normal group,the lpsilateral PI of DIND was increased progressively than contralateral PI.At the same time the Vm was decreased progressively than contralateral Vm and showed that them were early than the clinical symptoms(P<0.01).Conclusions:The TCD change of delayed cerebral vasospsm(DCVS) after SAH were difference between the basal arteryl and distant cerebral arterioles.Both change were early than the clinical symptoms.