经颅多普勒超声检查在急性颅脑外伤患者的应用

目的：探讨经颅多普勒（ＴＣＤ）超声早期发现急性颅脑损伤脑血管痉挛（ＣＶＳ）的临床应用价值。方法：应用ＴＣ２０００型ＴＣＤ诊断仪分别于伤后２４小时，３天，第１，２，和３周观察６３例脑外伤患者的双侧大脑中动脉ＭＣＡ颈内动脉（ＩＣＡ）的平均流速（Ｖｍ），ＭＣＡ／ＩＣＡ比值，脉动指数（ＰＩ）和阻抗指数（ＲＩ），结果：（１）ＴＣＤ与ＧＣＳ评分密度相关，≤７分者在３天内Ｖｍ可达高峰〉１２０ｃｍ／ｓ，〉７分者Ｖ

The Diagnostic Significance of Transcranial Doppler Ultrasound Examination in Acute Head Injuries

To investigate the clinical diagnostic value of transcranial Doppler ultrasound(TCD)for detecting early cerebral vasospasm during the treatment of acute head injuries. Method: TCD was performed at 24 hours, 3 days, 1 week, 2 weeks and 3 weeks after acute head injuries respectively, in order to examine the mean velocity (Vm) of bilateral middle cerebral artery (MCA) and internal carotid artery (ICA) from a depth of 50 - 60mm, through the temporal area, to calculate the ratio between the Vm/MCA and the bilateral Vm/ICA, denoted the hemispheric MCA(Vm)/ICA (Vm) index; to measure pulsitility index (PI) and resistance index (RI). Result: (1)There was significant correlation between TCD and GCS, Vm/ MCA could raise more than 120 cm/s in patients with less GCS 7 within 3 days, most of patients with more than GCS 7 were less than 90 cm/s, (2) the correlation between TCD and CT showed indexes of TCD was higher in the injuries than in the non-injury location or bilateral injury location. the latter was higher than normal value, (3)TCD as prognosis showed that the mortality was very high while Vm/MCIA raised suddenly to more than 140 cm/s or was suddenly dropped to less than 30 cm/s following head injuries, prognosis was satisfactory if Vm/MCA was less than 120 cm/s, (4) TCD could be helpful for the treatment of head injuries. Conclusion: the TC was non-invasive, safe, convenient for hemodynamic monitoring the onset of cerebral vasospasm,and could supply informations which could not be supplied by CT and DSA.