急性脑出血的经颅多普勒超声研究

目的：评价急性脑出血的脑血流动力学。方法：应用经颅多普勒超声（ＴＣＤ）对４０例急性脑出血病人测量了发病后４８小时内的大脑中动脉平均血流速（Ｖｍ）及脉动指数（ＰＩ）。根据ＣＴ测定脑出血量并与Ｖｍ及ＰＩ进行比较。结果：ＴＣＤ异常率７５％，异常表现为ＰＩ增高（６７．５％），Ｖｍ减慢（３２．５％）和Ｖｍ增快（５％）。出血量＞２５ｍｌ时出血侧ＰＩ增高，Ｖｍ减低。与小量出血比较，大量出血组（＞２５ｍｌ，１４例）的ＰＩ增高显著（Ｐ＜０．００５）。结论：研究发现大量脑出血可发生非对称的脑血流动力学改变，反映这种非对称性ＰＩ较Ｖｍ更可靠。

Study of Transcranial Doppler Sonography in Acute Intracerebral Hemorrhage

Objective:To evaluate the intracranial hemodynamics of acute intracerebral hemorrhage.Method:Transcranial Doppler sonography (TCD) was used to detect mean flow velocity (Vm) and pulsatility index (PI) of middle cerebral artery within 48 hours of onset in 40 patients with acute intracerebral homorrhage.Hematoma volumes was calculated from admission CT scans and was compared with Vm and PI.Results:Abnormal manifestation (30/40,75%) were that PI elevated (67.5%),Vm depressed (32.5%) and Vm elevated (5%).Ipsilateral PI were elevated and Vm depressed when intracerebral hemorrhage volumes exceeded 25 ml. Compared with patients with small hemorrhages,those with large hemorrhage (>25ml,N=14) had significantly higher PI (P<0.005).Conclusion:This study found asymmetry of intracranial hemodynamics assessed by TCD occurs when intracerebral hemorrhage volumes exceed 25 ml.Alterations of PI reflect this more reliably than Vm.