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目的:应用经颅多普勒超声(TCD)监测大面积脑梗死与腔隙性脑梗死血流动力学变化,并进行相关性分析。方法:选择2009年2月至2012年5月在广东省揭阳市人民医院及广州医学院附属第二医院收治的80例脑梗死患者作为研究对象,其中大面积脑梗死40例(A组)、腔隙性脑梗死40例(B组),选择同期正常(C组)36例作为对照。应用TCD进行脑血管血流动力学监测。结果:A组脑血流异常率为95%(38/40);B组脑血流异常率为75%(30/40);C组脑血流异常率为33%(12/36);A组血流异常率明显高于B、C组,差异有统计学意义(P<0.05),B组血流异常率明显高于C组(P<0.05)。A、B、C组脑血管狭窄患者分别为21、17、2例,A组、B组血管狭窄率较C组明显增多(P<0.05)。A组、B组流速减慢发生率较C组增多(P<0.05)。A组脑梗死病灶侧MCA、ICA、ACA的PI、RI较B、C组明显增大(P<0.05)。结论:应用TCD有助了解大面积脑梗死患者颅内血管血流动力学情况,为治疗、判断病情及预后提供参考依据,也可作为常规的脑血管病的排查手段。
Objective: To monitor the hemodynamic changes of large area cerebral infarction and lacunar infarction by transcranial Doppler ultrasound (TCD) and analyze the correlation. Methods: Eighty cerebral infarction patients admitted to Jieyang Municipal People’s Hospital of Guangdong Province and the Second Affiliated Hospital of Guangzhou Medical College from February 2009 to May 2012 were selected as the study subjects, including 40 cases of large-area cerebral infarction (group A) 40 cases of lacunar infarction (group B), select the same period normal (group C) 36 cases as a control. Cerebral vascular hemodynamics monitoring using TCD. Results: The abnormal rate of cerebral blood flow in group A was 95% (38/40), the rate of abnormal cerebral blood flow in group B was 75% (30/40), and the rate of abnormal cerebral blood flow in group C was 33% (12/36). The abnormal rate of blood flow in group A was significantly higher than that in group B and C (P <0.05). The rate of abnormal blood flow in group B was significantly higher than that in group C (P <0.05). A, B, C group of patients with cerebral vascular stenosis were 21,17,2 cases, A, B group vascular stenosis rate was significantly increased compared with C group (P <0.05). The incidence of slowing down in group A and group B was more than that in group C (P <0.05). The PI and RI of MCA, ICA and ACA in group A were significantly higher than those in group B and C (P <0.05). Conclusion: The application of TCD can help understand the intracranial vascular hemodynamics in patients with large area cerebral infarction, and provide a reference for the treatment and judgment of the disease and prognosis. It can also be used as routine investigation of cerebrovascular disease.