CAJ | 학술논문

目的研究重型颅脑损伤后血管形态及血流变化,探讨经颅多普勒( transcranial Dopple,TCD)超声结合CT血管造影(CT angiography,CTA)对重型颅脑损伤手术疗效及预后的判定作用. 方法对56例重型颅脑损伤患者术前及术后使用TCD动态监测,并使用128层螺旋CT行头颅CTA动态检查. 结果重型颅脑损伤后TCD、CTA显示脑血流及血管形态均发生改变.CTA显示以血管移位或狭窄为主者,TCD波谱多呈高阻力型改变,手术疗效良好；血管痉挛者,频谱呈高阻力型(手术疗效相对较好)或“钉子波”(手术疗效多不良)；血管闭塞者TCD多呈“钉子波”,手术疗效差. 结论 TCD反映脑血流速度,CTA表现脑血管形态改变,二者结合能有效判断脑灌注情况,是重型颅脑损伤手术疗效判定的良好方法 .
목적 연구중형로뇌손상후혈관형태급혈류변화,탐토경로다보륵( transcranial Dopple,TCD)초성결합CT혈관조영(CT angiography,CTA)대중형로뇌손상수술료효급예후적판정작용. 방법 대56례중형로뇌손상환자술전급술후사용TCD동태감측,병사용128층라선CT행두로CTA동태검사. 결과 중형로뇌손상후TCD、CTA현시뇌혈류급혈관형태균발생개변.CTA현시이혈관이위혹협착위주자,TCD파보다정고조력형개변,수술료효량호；혈관경련자,빈보정고조력형(수술료효상대교호)혹“정자파”(수술료효다불량)；혈관폐새자TCD다정“정자파”,수술료효차. 결론 TCD반영뇌혈류속도,CTA표현뇌혈관형태개변,이자결합능유효판단뇌관주정황,시중형로뇌손상수술료효판정적량호방법 .
Objective To observe the changes of cerebral vascular morphology and blood flow after craniocerebral trauma so as to investigate the role of transcranial Doppler sonography (TCD) combined with CT angiography (CTA) in judgment of the operative effect and prognosis of severe craniocerebral trauma. Methods A total of 56 patients with craniocerebral trauma were monitored dynamically by using TCD before and after surgery.Dynamic CTA of head was also performed by using 128-slice spiral CT. Results TCD and CTA indicated that both the cerebral blood flow and vascular morphologychanged after craniocerebral trauma.CTA manifested mainly the vascular displacement or angiostegnosis and TCD showed mainly the high-resistance blood flow,indicating good operative effect.For the patients with vasospasm,the TCD manifested high-resistance flow (relatively good operative effect) or "nail flow"(mostly poor operative effect). The patients with vascular occlusion were associated with nail flow on TCD,with poor operative effect. Conclusions TCD shows the velocity of cerebral blood flow and CTA shows the morphological change of cerebral vessels.Thereby,the combination of TCD and CTA can effectively judge the cerebral perfusion and provide a promising way for validating the operative effect and prognosis of craniocerebral trauma.