脑出血后脑血流动力改变及钙拮抗剂对其影响的经颅多普勒动态观察

目的：探讨脑出血后脑动脉血流动力的改变及钙拮抗剂对其的影响。方法：回顾25例脑出血患及15例使用尼莫地平的脑出血患病后48小时内至病后4周的经颅多普勒（TCD）动态观察资料。以大脑中动脉（MCA）的平均血流速度（Vm)及脉动指数（PI）为指标进行对比分析，结果：脑出血后两侧MCA的Vm均可降低，PI均可增高，但血肿侧较对侧更为显，病后1周左右上述改变最为显，病后4周左右 恢复至病初水平；尼莫地平可使脑出血后脑血液动力学参数的改变程度减轻，恢复至病初水平的时间缩短。结论：脑出血后血肿占位效应和由此引起的脑组织缺血水肿是脑出血致死致残的主要原因之一，TCD可通过对脑底动脉流速、阻力指数的观察，对其发生、演变及严重程度进行判断。尼莫地平可以改善脑血肿周围缺血状态，对改善预后有积极作用。

DYNAMIC OBSERVATION OF TRANSCRANIAL DOPPLER ON HEMODYNAMIC CHANGE AND THE EFFECT OF CALCIUM ANTAGONISTS AFTER INTRACEREBRAL HEMORRHAGE

Objective: To study the hemodynamic change of celebral arteria and effect of the calcium antagonists after intracerebral hemorrhage (ICH) . Methods: By retrospective study of 25 cases with ICH and their 15 cases used Nimodipine probed the hemodynamic change with TCD in 48 hours - 4 weeks of onset and contrast analysed with mean velosity of blood flow (Vm) and Pulsatility index (PI) of middle cerebral artery (MCA) . Results: The Vm of MCA in bothside was decreased, but the PI was increased, and the hemorrhage side varied more obviously. The hemodynamic change varied significantly at 1 week and restored at 4 week of onset . Nimodipine can reduce not only the degree of hemodynamic change but also shorten the time of restoration. Conclusion: One of the leading died causes after ICH was edema affected by ischemia and mass effect around the hemotoma. Throught Vm and PI in base cranial arteria, TCD can observe they variation and severity of the bleeding. Nimodipine can improved the cerebral ischemic condition around the hemotoma and prognosis.