| 刘会 荣良群 魏秀娥 朱本亮 杨森 袁勇 王兰琴.基于卒中登记的颅内动脉瘤致蛛网膜下腔出血的临床研究[J].,2014,14(34):6689-6692 |
| 基于卒中登记的颅内动脉瘤致蛛网膜下腔出血的临床研究 |
| Clinical Research on Aneurysmal Subarachnoid Hemorrhage Basedon Stroke Registry |
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| DOI： |
| 中文关键词: 蛛网膜下腔出血 颅内动脉瘤 卒中登记 经颅多普勒超声 脑血管痉挛 |
| 英文关键词: Subarachnoid hemorrhage Aneurysm Stroke registry Transcranial Doppler Cerebral vasospasm |
| 基金项目:徐州市科技计划项目(XM09B085） |
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| 中文摘要: |
| 目的：研究基于卒中登记的颅内动脉瘤致蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage, aSAH）的颅脑血流动力学
改变及其对诊断治疗的指导作用。方法：采用回顾性研究经卒中登记系统筛选出48 例经DSA（digital subtraction angiography,
DSA）确诊的aSAH，收集患者床旁经颅多普勒（transcranial Doppler, TCD）监测大脑中动脉（middle cerebral artery, MCA）的动脉平
均峰值流速（mean blood velocity, Vm）、搏动指数（pulsatility index, PI）、阻力指数（resistance index, RI），自身健侧作为正常对照，均
采用血管内介入治疗，对其中符合脑血管痉挛（cerebral vasospasm, CVS）诊断标准的患者使用尼莫地平进行治疗，观察疗效。结
果：与健侧相比，患侧PI、RI增大，Vd、Vm减小，其中以Vd 减小较明显，与健侧相比有统计学差异（P＜0.01），Vs与健侧相比无统
计学差异（P＞0.05）。CVS 组与非CVS组相比Vm明显增加，有统计学差异（P＜0.001）。所有患者经水膨胀弹簧圈或支架预后均
得到改善。结论：床旁实时TCD监测能反映aSAH脑血流变化，对CVS 进行及时解除痉挛治疗，并为介入治疗提供参考依据，颅
脑血流实时监测和介入治疗综合运用提高了aSAH患者的治疗效果。 |
| 英文摘要: |
| Objective:To study the brain blood flow change and its benefit for the diagnosis and treatment of aneurysmal
subarachnoid hemorrhage (aSAH) based on stroke registry.Methods:A retrospective single center method based on stroke registry was
applied in this study and 48 patients’clinical data with aSAH diagnosed by digital subtraction angiography (DSA) were registered, which
contained transcranial Doppler (TCD) parameters including the mean blood velocity (Vm), pulsatility index (PI), and resistance index
(RI) of the middle cerebral artery (MCA), with a control of self healthy side. All patients were treated with interventional therapy and the
results were collected and analyzed, in which there were some cerebral vasospasm (CVS) detected and treated with Nimodipine.Results:The data of TCD show that PI and RI were increased, and Vd and Vmdecreased, in which there were statistical significance in PI, RI, Vd
and Vm between ill side and healthy side (P＜0.01). And there were no statistical significance in Vs (P＞0.05). There were statistical
differences in Vm between CVS group and non CVS group, P＜0.001. All the patients were relieved by interventional therapy with the
water expansion spring coil or stents.Conclusion:The parameters of TCD could reflect the changes of brain blood flow, which were
helpful for the diagnosis and treatment of aSAH. And it is also helpful for the personalized treatment of CVS detected by TCD and for the
decrease of lethality and disability of aSAH. |
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