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目的 观察脑出血后脑主要动脉的血流速度变化,进而研究脑血流动力学变化的临床价值。方法 采用经颅超声多普勒(transcranial Doppler,TCD)分别对216例脑出血患者和80名健康对照者的大脑中动脉、大脑前动脉、大脑后动脉、颈内动脉、基底动脉和椎动脉等颅内主要动脉的血流速度进行检测分析,记录包括收缩期峰速(Vs)、舒张期末流速(Vd)及搏动指数(PI)等血流参数及频谱形态。结果 脑出血组患者收缩期峰速与舒张末期流速与对照组比较均降低,差异有显著性意义(P<0.001)。脑出血组有164例患者(7.93％)颅内动脉血流速度降低,其中51例(23.61％)发生于脑出血早期,以舒张期末流速降低为主,113例(52.31％)发生于脑出血的中、后期,表现为普遍性流速降低。另有52例(24.07％)脑血流速度基本正常。结论 多数脑出血患者脑组织处于低循环状态,其程度与病情相关,因此对脑出血患者进行血流动力学监测有助于指导治疗及判断预后。
Objective To observe the changes of blood flow velocity of cerebral artery after intracerebral hemorrhage and to study the clinical value of cerebral hemodynamics. Methods Transcranial Doppler (TCD) was used to evaluate the effects of transcranial doppler (TCD) on middle cerebral artery, anterior cerebral artery, posterior cerebral artery, internal carotid artery, basilar artery and vertebral artery in 216 patients with cerebral hemorrhage and 80 healthy controls respectively The blood flow velocities of the main intracranial arteries were detected and recorded. The blood flow parameters such as peak systolic velocity (Vs), end-diastolic velocity (Vd) and pulsatility index (PI) and spectral shapes were recorded. Results The peak systolic velocity and end diastolic velocity of cerebral hemorrhage patients were significantly lower than those of the control group (P <0.001). Intracranial hemorrhage group, 164 patients (7.93%) had decreased intracranial arterial blood flow velocity, of which 51 (23.61%) occurred in the early stage of cerebral hemorrhage and decreased in the end diastole, 113 (52.31%) occurred in cerebral hemorrhage In the late, the performance of the universal flow rate decreased. Another 52 cases (24.07%) of cerebral blood flow velocity was normal. Conclusion Most cerebral hemorrhage in patients with brain tissue in a low circulation state, the extent and disease-related, so the hemodynamic monitoring of patients with cerebral hemorrhage will help guide the treatment and prognosis.