经颅多普勒超声研究甘露醇对颅脑损伤的作用

用经颅多普勒(TCD)超声检查45例重型颅脑损伤,观察在常规静脉输注甘露醇后大脑中动脉血流速度频谱的变化。结果发现,20例正向Vd持续存在的患者,对甘露醇反应灵敏,用后频谱可得到改善。另25例,Vd先后消失、进而反向,此时应用甘露醇频谱无变化。揭示TCD有助于选择甘露醇的适应证。

Study of the effect of mannitol on head injury with transcranial Doppler

A transcranial Doppler (TCD)ultrasonic diagnostic apparatus was used to observe the changes ofthe velocity of blood flow in the middle cerebral artery (FVmca)in 45 severe head injury patients byadopting routine venous infusion of mannitol. The results showed that there was a continued reserva-tion of antegrade end-diastolic velocity(Vd)and a distinct improvement of spectra of FVmca after theuse of mannitol in 20 cases. In the other 25 patients,the diastolic part of the flow velocity spectrumdisappeared successively. A signal with retrograde flow throughout the diastole was finally observed.At that time,there was no effect of mannitol on the spectra of FVmca in the whole series. It was indi-cated that TCD could help to select indications and to explore the mechanism of mannitol.