重型脑外伤后脑血管血流速变化的TCD研究

目的　研究重型脑外伤后脑血管血流速的变化及对预后的影响。方法　采用经颅多普勒 (TCD)对 2 8例重型脑外伤 (GCS评分 3～ 8分 )和 2 6例轻中型脑外伤 (GCS 9～ 1 5分 )患者进行连续监测 2周 ,记录每d大脑中动脉 (MCA)平均流速变化 ,分析流速与颅内压 (ICP)、蛛网膜下腔出血 (SAH)、预后评分 (GOS)的联系。结果　重型脑外伤组脑血管血流速在伤后第2天开始升高 (P <0 .0 5) ,第 5天达到高峰 ,以后逐步下降 ,2周时仍高于正常 (P <0 .0 5)。轻中型脑外伤组仅在伤后第 3～ 4天升高 (P <0 .0 5)。血流速与SAH有明显联系 ,与ICP ,GOS无相关性。结论　重型脑外伤后脑血管血流速会加快 ,但对预后无较大影响

Study on variation of cerebral blood flow velocity after severe head injury with TCD

Objective It is to investigate the variation of cerebral artery flow velocity (FV) after severe head injury. Methods Twenty eight patients with severe head injury whose Glasgow coma scale (GCS) ranged from 3 to 8 and twenty six patients with low grade or medium grade head injury whose GCS ranged from 9 to 15 had been inspected for two weeks. The mean FV of the middle cerebral artery (mFV MCA ) was recorded and its relation to intracranial pressure (ICP), subarachnoid hemorrhage (SAH) and Glasgow outcome scale (GOS) were analyzed. Results The mFV MCA of the severe head injury group gradually increased after two days and reached peak on the fifth day ( P <0.05), then declined gradually, but was still higher than that of normal. The mFV MCA of the low grade or medium grade head injury group was higher ( P <0.05) only on the third day and the fourth day. There was significant relation between SAH and mFV MCA . The relation with ICP and GOS was not identified. Conclusion mFV MCA of severe head injury patients is high but has no significant effect on outcome.