中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
2期
112-115
,共4页
雷晋%高国一%宋绍莉%郑秀娟%梁玉敏%潘耀华%包映晖%丁圣豪%江基尧
雷晉%高國一%宋紹莉%鄭秀娟%樑玉敏%潘耀華%包映暉%丁聖豪%江基堯
뢰진%고국일%송소리%정수연%량옥민%반요화%포영휘%정골호%강기요
右正中神经电刺激%外伤性脑损伤%昏迷%单光子发射计算机断层扫描-计算机断层扫描
右正中神經電刺激%外傷性腦損傷%昏迷%單光子髮射計算機斷層掃描-計算機斷層掃描
우정중신경전자격%외상성뇌손상%혼미%단광자발사계산궤단층소묘-계산궤단층소묘
Right median nerve electrical stimulation%Traumatic brain injury%Coma%SPECT- CT
目的 利用SPECT - CT融合机脑血流灌注显像技术检测重型颅脑创伤昏迷患者行右正中神经电刺激前后脑血流灌注变化情况.方法 重型颅脑损伤患者32例,伤后2周仍昏迷,接受右正中神经电刺激治疗.治疗前及治疗第7天,行SPECT - CT评价脑血流灌注变化情况.利用MATLAB和SPM软件对检测结果进行分析处理,得到昏迷患者脑皮层丘脑血流与健康成人比较值,用区域分析法分析脑皮层、丘脑和脑干部位的血流灌注增加的特征改变,利用图像重建迭加技术获得脑表面(含颅底面)血流灌注增加值.结果 颅脑创伤昏迷患者与健康成人相比较,其感觉运动皮层、双侧丘脑和脑干部位脑血流灌注出现明显下降,经电刺激治疗后,患者缺血部位脑血流明显改善,且额叶底面、海马回等区域也出现血流灌注增加表现.结论 颅脑创伤昏迷状况下存在脑血流灌注低下区域,右正中神经电刺激术不仅可显著改善颅脑创伤昏迷患者皮层及丘脑和脑干血流灌注状况,而且可以增加额叶、颞叶底面皮质的血流灌注,提示右正中神经电刺激可能通过改善脑重要功能部位血流状况达到促醒作用.
目的 利用SPECT - CT融閤機腦血流灌註顯像技術檢測重型顱腦創傷昏迷患者行右正中神經電刺激前後腦血流灌註變化情況.方法 重型顱腦損傷患者32例,傷後2週仍昏迷,接受右正中神經電刺激治療.治療前及治療第7天,行SPECT - CT評價腦血流灌註變化情況.利用MATLAB和SPM軟件對檢測結果進行分析處理,得到昏迷患者腦皮層丘腦血流與健康成人比較值,用區域分析法分析腦皮層、丘腦和腦榦部位的血流灌註增加的特徵改變,利用圖像重建迭加技術穫得腦錶麵(含顱底麵)血流灌註增加值.結果 顱腦創傷昏迷患者與健康成人相比較,其感覺運動皮層、雙側丘腦和腦榦部位腦血流灌註齣現明顯下降,經電刺激治療後,患者缺血部位腦血流明顯改善,且額葉底麵、海馬迴等區域也齣現血流灌註增加錶現.結論 顱腦創傷昏迷狀況下存在腦血流灌註低下區域,右正中神經電刺激術不僅可顯著改善顱腦創傷昏迷患者皮層及丘腦和腦榦血流灌註狀況,而且可以增加額葉、顳葉底麵皮質的血流灌註,提示右正中神經電刺激可能通過改善腦重要功能部位血流狀況達到促醒作用.
목적 이용SPECT - CT융합궤뇌혈류관주현상기술검측중형로뇌창상혼미환자행우정중신경전자격전후뇌혈류관주변화정황.방법 중형로뇌손상환자32례,상후2주잉혼미,접수우정중신경전자격치료.치료전급치료제7천,행SPECT - CT평개뇌혈류관주변화정황.이용MATLAB화SPM연건대검측결과진행분석처리,득도혼미환자뇌피층구뇌혈류여건강성인비교치,용구역분석법분석뇌피층、구뇌화뇌간부위적혈류관주증가적특정개변,이용도상중건질가기술획득뇌표면(함로저면)혈류관주증가치.결과 로뇌창상혼미환자여건강성인상비교,기감각운동피층、쌍측구뇌화뇌간부위뇌혈류관주출현명현하강,경전자격치료후,환자결혈부위뇌혈류명현개선,차액협저면、해마회등구역야출현혈류관주증가표현.결론 로뇌창상혼미상황하존재뇌혈류관주저하구역,우정중신경전자격술불부가현저개선로뇌창상혼미환자피층급구뇌화뇌간혈류관주상황,이차가이증가액협、섭협저면피질적혈류관주,제시우정중신경전자격가능통과개선뇌중요공능부위혈류상황체도촉성작용.
Objective To investigate the effect of right median nerve electrical stimulation on cerebral blood infusion of traumatic coma patients with SPECT - CT. Methods Thirty - two severely traumatic brain injured patients undergone operation and intensive management received right median nerve electrical stimulation after diagnosing low consciousness state (GCS ≤ 8 ) at two weeks after injury. The measurements of cerebral blood infusion with SPECT - CT were carried out 1 day before initiation of electric treatment and 7 days thereafter. The results were compared and analyzed using matlab and statistical parameter mapping analyzing software.Results The cerebral blood infusions were significantly decreased on frontal lobe,thalamus and brain stem in coma patients.Electrical treatment induced profound increment of blood infusion in motor - sensor cortex,straight gyrus and hippocampus gyrus.The blood infusion in upper brain stem also increased after one week electric treatment. Conclusion Right median nerve electrical stimulation may benefit the recovery of impacted consciousness of head trauma patients through the increment of brain blood infusion in specific consciousness related brain areas.
