彩色多普勒超声在高血压脑出血显微手术及围术期脑血流动力学监测中的应用价值

doi:10.7517/issn.1674-0475.200510

摘要/Abstract

摘要： 本研究探讨彩色多普勒超声在高血压脑出血（HICH）显微手术及围术期脑血流动力学监测中的应用价值。选取HICH患者87例，分为超声引导组和常规手术组。采用经颅彩色多普勒超声监测患者大脑中动脉围术期血流动力学参数，并比较血肿清除率、脑梗死发生率，以及近、远期疗效。结果显示，超声引导组术后第2天血肿清除率高于常规手术组（P<0.05），术后7天脑梗死发生率低于常规手术组（P<0.05），近、远期疗效均优于常规手术组（P<0.05）。与常规手术组比较，超声引导组术后7天的收缩期峰血流速度（Vs）、舒张期末血流速度（Vd）、平均血流速度（Vm）升高，搏动指数（PI）降低（P<0.05）。表明彩色多普勒超声可有效监测HICH患者脑血流动力学改变，术中实时超声引导可准确定位颅内血肿位置，提高血肿清除率，有利于改善预后。

关键词: 高血压脑出血, 显微手术, 彩色多普勒超声, 脑血流动力学, 血肿清除率

Abstract: The application value of color Doppler ultrasound in microsurgery and perioperative monitoring of cerebral hemodynamics in hypertensive intracerebral hemorrhage (HICH) is analyzed in this study. 87 patients with HICH were divided into ultrasound-guided group and conventional operation group. The hemodynamic parameters of middle cerebral artery were monitored by transcranial color Doppler ultrasound. The clearance rate of hematoma, incidence of cerebral infarction, short-term and long-term effects were compared. The results showed that the clearance rate of hematoma of ultrasound-guided group was higher than that of conventional operation group on the 2 days postoperative (P<0.05), the incidence of cerebral infarction was lower than that of conventional operation group on the 7 days postoperative (P<0.05), and the short-term and long-term effects were better than those of conventional operation group (P<0.05). Compared with the conventional operation group, the Vs, Vd, Vm of ultrasound-guided group were increased, PI was decreased on the 7 days postoperative (P<0.05). Therefore, color Doppler ultrasound is an effective method to monitor the changes of cerebral hemodynamics in HICH. Real-time ultrasound guidance can accurate the location of intracranial hematoma, improve the clearance rate of hematoma, and improve the prognosis.

Key words: hypertensive intracerebral hemorrhage, microsurgery, color Doppler ultrasound, cerebral hemodynamics, clearance rate of hematoma

范少平, 安模, 杨波, 吕春潮, 梁碧先, 黎姣. 彩色多普勒超声在高血压脑出血显微手术及围术期脑血流动力学监测中的应用价值[J]. 影像科学与光化学, 2020, 38(6): 1056-1060.

FAN Shaoping, AN Mo, YANG Bo, LYU Chunchao, LIANG Bixian, LI Jiao. Application Value of Color Doppler Ultrasound in Microsurgery and Perioperative Monitoring of Cerebral Hemodynamics in HICH[J]. Imaging Science and Photochemistry, 2020, 38(6): 1056-1060.

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