中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2012年
2期
160-163
,共4页
超声检查,多普勒,经颅%颅内高压%颅内压%脑%血液动力学现象
超聲檢查,多普勒,經顱%顱內高壓%顱內壓%腦%血液動力學現象
초성검사,다보륵,경로%로내고압%로내압%뇌%혈액동역학현상
Ultrasonography,Doppler,transcranial%Intracranial hypertension%Intracranial pressure%Brain%Hemodynamic phenomena
目的 探讨兔不同程度颅内高压状态下经颅彩色多普勒(TCD)频谱和参数改变.方法 60只实验兔随机分为3组:对照组、轻中度颅高压组、重度颅高压组,采用硬膜外球囊注水法制作急性局灶性颅内高压模型,监测颅内压(ICP)、脑灌注压(CPP)及TCD参数,颅内高压组给予甘露醇治疗,观察ICP及TCD参数变化.结果 轻中度颅高压组出现高阻力血流频谱、收缩峰频谱.重度颅高压组在兔颅内压升高终末期,依次出现三种特征性TCD频谱:舒张期逆向血流、极小的收缩峰和无信号.其中舒张期逆向血流形态呈与脑死亡阶段相关的多样性.极小的收缩峰图形可表现为针式、小三角形和双峰型.给予甘露醇治疗后,轻中度颅高压组ICP下降,TCD表现好转；重度颅高压组ICP及TCD表现无明显好转.结论 TCD能间接评估颅内高压,具有判定病情、指导治疗、观察疗效的意义.
目的 探討兔不同程度顱內高壓狀態下經顱綵色多普勒(TCD)頻譜和參數改變.方法 60隻實驗兔隨機分為3組:對照組、輕中度顱高壓組、重度顱高壓組,採用硬膜外毬囊註水法製作急性跼竈性顱內高壓模型,鑑測顱內壓(ICP)、腦灌註壓(CPP)及TCD參數,顱內高壓組給予甘露醇治療,觀察ICP及TCD參數變化.結果 輕中度顱高壓組齣現高阻力血流頻譜、收縮峰頻譜.重度顱高壓組在兔顱內壓升高終末期,依次齣現三種特徵性TCD頻譜:舒張期逆嚮血流、極小的收縮峰和無信號.其中舒張期逆嚮血流形態呈與腦死亡階段相關的多樣性.極小的收縮峰圖形可錶現為針式、小三角形和雙峰型.給予甘露醇治療後,輕中度顱高壓組ICP下降,TCD錶現好轉；重度顱高壓組ICP及TCD錶現無明顯好轉.結論 TCD能間接評估顱內高壓,具有判定病情、指導治療、觀察療效的意義.
목적 탐토토불동정도로내고압상태하경로채색다보륵(TCD)빈보화삼수개변.방법 60지실험토수궤분위3조:대조조、경중도로고압조、중도로고압조,채용경막외구낭주수법제작급성국조성로내고압모형,감측로내압(ICP)、뇌관주압(CPP)급TCD삼수,로내고압조급여감로순치료,관찰ICP급TCD삼수변화.결과 경중도로고압조출현고조력혈류빈보、수축봉빈보.중도로고압조재토로내압승고종말기,의차출현삼충특정성TCD빈보:서장기역향혈류、겁소적수축봉화무신호.기중서장기역향혈류형태정여뇌사망계단상관적다양성.겁소적수축봉도형가표현위침식、소삼각형화쌍봉형.급여감로순치료후,경중도로고압조ICP하강,TCD표현호전；중도로고압조ICP급TCD표현무명현호전.결론 TCD능간접평고로내고압,구유판정병정、지도치료、관찰료효적의의.
Objective To investigate the changes of transcranial Doppler (TCD) patterns and parameters in various intracranial hypertension.Methods Sixty rabbits were randomized into 3 groups:control group,the group of mild-to-moderate intracranial hypertension,the group of serious intracranial hypertension.Acute intracranial hypertension was induced by inflating the balloon inserted into the epidural space.Blood flow velocity was measured with TCD and intracranial pressure (ICP) as well as cerebral perfusion pressure(CPP) was measured.Mannitol was injected to the animals of intracranial hypertension,blood flow velocity and ICP was measured.Results Two characteristic flow patterns vere observed in the group of mild-to-moderate intracranial hypertension:high resistance pattern,systolic flow.At the last stage of extreme intracranial hypertension in the group of serious intracranial hypertension Doppler sonograms showed three characteristic flow patterns in the following sequence:retrograde diastolic flow,very small systolic flow and zero flow.Multiform retrograde diastolic flows were related to the phases of brain death.Very small systolic flow showed three shapes:systolic-spike,small systolic triangular and small double peak.After medicinal treatment ICP decreased in the the group of mild-to-moderate intracranial hypertension,blood flow velocity also increased.After the same treatment IC,P and blood flow velocity did not change in the group of serious intracranial hypertension.Conclusions Analysing patterns and parameters of TCD may be helpful for evaluating ICP indirectly as well as clinical experience.
