术中微血管多普勒监测在急性期动脉瘤夹闭术中的应用

目的 探讨术中微血管多普勒监测在急性期动脉瘤夹闭术中对脑血管血流动力学评定的应用价值和可靠性,以及其结果对手术过程的影响.方法 对62例破裂动脉瘤患者在行急性期动脉瘤夹闭术中应用微血管多普勒监测,分别于夹闭前、后测量瘤体、载瘤动脉及邻近血管的血液流速及波谱改变,其结果与目测动脉瘤夹的位置和术后复查DSA或三维CT血管成像进行对照分析.结果 术中微血管多普勒监测证实视觉无法发现的因动脉瘤夹引起的邻近血管狭窄12例;证实动脉瘤体夹闭不全4例;据其结果调整动脉瘤夹位置16例,38例与术后复查DSA或三维CT血管成像结果相符合.结论 在急性期动脉瘤夹闭术中应用微血管多普勒监测是一种安全、快速、可靠、高效的技术.

Intraoperative microvascular Doppler ultrasonography in urgent clipping surgery for application of ruptured aneurysms

Objective To evaluate the efficacy and reliability of intraoperative microvascular Doppler uhrasonography (IMDU)in urgent clipping surgery of ruptured aneurysms,and assess the impact of this method on the surgical procedure itself.Methods For 62 patients who underwent urgent clipping surgery for the treatment of ruptured aneurysms,both blood flow velocities in the aneurismal sac and in the adjacent vessels and alterations of the Doppler spectrum were determined by IMDU before and after aneurysm clipping.The findings of IMDU were analysed and compared with those of visual inspection of the surgical site and postoperative angiography. Results A relevant stenosis of an adjacent vessel induced by efip position that had escaped detection by visual inspection was identified by IMDU in 12 out of 62 patients.In addition, IMDU demonstrated a primarily incomplete clipping aneurysm in 4 out of 62 patients.The clipping aneurysm was repositioned on the basis of the IMDU findings in 16 out of 62 patients.The findings from IMDU equated with those from angiography in 38 eases.Conclusion IMDU is a safe,instantaneous,effective and reliable technique for the urgent dipping surgery of raptured aneurysms.