摘要
目的了解颅脑损伤患者脑血流动力学参数（ＣＨＩ）的变化规律，并探讨其与颅内压（ＩＣＰ）的关系。方法利用国产ＣＨＩ检测仪分别对４３例中、重型颅脑损伤患者，检测伤后１～３ｄ、５ｄ、１０ｄ的ＣＨＩ，并与正常对照组比较；３０例颅脑损伤患者使用了国产ＩＣＰ监测仪或腰穿测压，并同步检测ＣＨＩ。结果中、重型颅脑损伤，伤侧半球血流速度、血流量均显著下降。中型颅脑损伤的对侧半球，伤后脑最大血流速度及流量显著增加。而在重型颅脑损伤，对侧半球与伤侧半球ＣＨＩ呈平行发展趋势，以伤后第３ｄ偏离正常值最远。同步测得ＣＨＩ与ＩＣＰ值，在ＩＣＰ＜４ｋＰａ时，无显著相关关系。结论中、重型颅脑损伤，脑血管外周阻力、动态阻力增大、顺应性变差、自动调节能力下降导致脑血流速度减慢，血流量明显下降；ＩＣＰ＜４ｋＰａ时。
Objective To explore the change of cerebral hemodynamic indexes(CHI) and the relationship between it and the change of intracranial pressure(ICP) in patients with brain injury.Methods CHI of 43 patients with moderate or severe injuried head on 1d～3d, 5d, 10d after injury and that of controls were measured using a domestic CHI meter, and then the results of the former two groups were compared with that of controls seperately.ICP was measured with domestic ICP meter or by lumbar puncture and CHI values were obtained at the same time in 30 among all the 43 cases .Results Both the velocity and flow quantum of blood in injuried hemisphere decreased significantly.The maximum velocity and flow quantum of blood of contra hemisphere increased markedly in moderate brain injury.While the CHI in both hemisphere trended to get farther from the normal value with time and reached the farthest points on the 3d after injury.The CHI and ICP values obtained simutaneously.There was no remarkable correlation in them (ICP<4 kPa).Conclusion Decrease of the velocity and flow quantum of blood in moderate and severe injuried brain was caused due to the increase of cerebrovascular external resistance and dynamic resistance,the decrease of the compatibility and automatic regulating capability of brain blood vesssel.ICP was not main factor that affected the change of CHI.
出处
《临床神经病学杂志》
CAS
1998年第5期264-268,共5页
Journal of Clinical Neurology
关键词
脑损伤
血流动力学
颅内压
Brain injury Hemodynamics Intracranial pressure
