临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
JOURNAL OF CLINICAL NEUROSURGERY
2015年
2期
103-106
,共4页
曹一波%封灏%于君%韩宁%马晶%闫洪生%李献福%甄杰%陈银海%侯英泊%马亚辉%金纬%丁玉珀%刘暌
曹一波%封灝%于君%韓寧%馬晶%閆洪生%李獻福%甄傑%陳銀海%侯英泊%馬亞輝%金緯%丁玉珀%劉暌
조일파%봉호%우군%한저%마정%염홍생%리헌복%견걸%진은해%후영박%마아휘%금위%정옥박%류규
颅脑损伤%CT灌注成像%局部脑血流量
顱腦損傷%CT灌註成像%跼部腦血流量
로뇌손상%CT관주성상%국부뇌혈류량
brain injury%computed tomography perfusion imaging%regional cerebral blood flow
目的：通过螺旋CT灌注成像（ CTP）检测局部脑血流参数，探讨其在中、重度颅脑损伤中的相关性，对比研究其变化规律。方法根据格拉斯哥昏迷量表（ GCS）评分选择32例中型和重型颅脑损伤患者进行CTP检查，检测局部脑血流量（rCBF）、局部脑血容积（rCBV）、血液通过组织的平均通过时间（MTT），分析三者间的相关性及其与颅脑损伤程度的关系。结果患者脑组织损伤部位的rCBV和rCBF明显低于对侧，MTT显著高于对侧（均P＜0．05）；重型组rCBF和rCBV明显低于中型组（均P＜0．05）。手术组患者术前与术后第3 d对比，患侧rCBV明显高于术前，而术后MTT则显著低于术前（均P＜0．05）；中、重型颅脑损伤患者创伤部位的rCBV与格拉斯哥预后量表（ GOS）评分呈正相关，而MTT、 rCBF与GOS评分无相关性。结论通过CTP检测患者损伤部位的rCBF、rCBV和MTT可判断脑损伤的程度和预后，对指导临床医师治疗有着重要的意义。
目的：通過螺鏇CT灌註成像（ CTP）檢測跼部腦血流參數，探討其在中、重度顱腦損傷中的相關性，對比研究其變化規律。方法根據格拉斯哥昏迷量錶（ GCS）評分選擇32例中型和重型顱腦損傷患者進行CTP檢查，檢測跼部腦血流量（rCBF）、跼部腦血容積（rCBV）、血液通過組織的平均通過時間（MTT），分析三者間的相關性及其與顱腦損傷程度的關繫。結果患者腦組織損傷部位的rCBV和rCBF明顯低于對側，MTT顯著高于對側（均P＜0．05）；重型組rCBF和rCBV明顯低于中型組（均P＜0．05）。手術組患者術前與術後第3 d對比，患側rCBV明顯高于術前，而術後MTT則顯著低于術前（均P＜0．05）；中、重型顱腦損傷患者創傷部位的rCBV與格拉斯哥預後量錶（ GOS）評分呈正相關，而MTT、 rCBF與GOS評分無相關性。結論通過CTP檢測患者損傷部位的rCBF、rCBV和MTT可判斷腦損傷的程度和預後，對指導臨床醫師治療有著重要的意義。
목적：통과라선CT관주성상（ CTP）검측국부뇌혈류삼수，탐토기재중、중도로뇌손상중적상관성，대비연구기변화규률。방법근거격랍사가혼미량표（ GCS）평분선택32례중형화중형로뇌손상환자진행CTP검사，검측국부뇌혈류량（rCBF）、국부뇌혈용적（rCBV）、혈액통과조직적평균통과시간（MTT），분석삼자간적상관성급기여로뇌손상정도적관계。결과환자뇌조직손상부위적rCBV화rCBF명현저우대측，MTT현저고우대측（균P＜0．05）；중형조rCBF화rCBV명현저우중형조（균P＜0．05）。수술조환자술전여술후제3 d대비，환측rCBV명현고우술전，이술후MTT칙현저저우술전（균P＜0．05）；중、중형로뇌손상환자창상부위적rCBV여격랍사가예후량표（ GOS）평분정정상관，이MTT、 rCBF여GOS평분무상관성。결론통과CTP검측환자손상부위적rCBF、rCBV화MTT가판단뇌손상적정도화예후，대지도림상의사치료유착중요적의의。
Objective To investigate the correlation between the severity of brain injury and regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV) or mean transition time (MTT) .Methods 32 patients of brain injury were included and divided into moderate and severe group based on their GCS scores . The rCBF, rCBV and MTT were determined by computed tomography perfusion ( CTP) imaging after admittion .Results rCBV and rCBF of injured area were significantly lower than that in contralateral side , and MTT was significantly higher (all P<0.05). The rCBF and rCBV of severe group were lower than in the moderate group (all P<0.05).Compared with preoperative and postoperative data , postoperative rCBV was significantly higher than the preoperative , and postoperative MTT was significantly lower than the preoperative .The rCBV and the GOS score was positively correlated , whereas there was no correlation between rCBF and the GOS score.Conclusion rCBF, rCBV and MTT were closely correlated with the severity as well as the prognosis of patients with acute brain injury ,which may be a sensitive index to determine the extent of brain damage and prognosis prediction , and have great significance to guide clinical treatment .
