床旁经颅多普勒在重症脑血管病监护中的应用

doi:10.3969/j.issn.1673-5765.2018.05.024

摘要/Abstract

摘要：

经颅多普勒（transcranial doppler，TCD）的2MHz超声探头可以透过颅骨薄弱部位实时动态监测颅底Willis环组成的血管血流速度，从而得到脑血流动力学等参数，在重症脑血管病领域得到了广泛的应用。TCD一直是蛛网膜下腔出血床旁诊断的有力武器，但是TCD诊断的血管痉挛对临床预后的判断受到临床挑战。血管再通迎来春天，床旁TCD可以对血管再通治疗后高灌注综合征的发生起到预警作用，而且可以随访检测血管再通的治疗效果。TCD对于无创颅内压监测的指示作用有待国际公认的可重复的数学模型出现。

文章导读： 经颅多普勒可以实现对重症脑血管患者的实时、连续的床旁监护。本文综述了其对于重症蛛网膜下腔出血、缺血性卒中和脑出血患者的临床价值。

关键词: 经颅多普勒; 重症监护; 脑血管病; 床旁监护

Abstract:

Transcranial Doppler (TCD) is a kind of convenient noninvasive ultrasound equipment. Its 2 MHz ultrasonic probe can pass through the skull weak parts and monitor blood flow velocity real-timely, so that the cerebral hemodynamic parameters are obtained, which is applied widely in the field of severe cerebrovascular diseases. TCD is also a useful tool for bedside diagnosis of subarachnoid hemorrhage. However, TCD diagnosis of vascular spasm for evaluating clinical prognosis faced some challenge. Now it is the era of endovascular treatment, and the bedside TCD can be used in early diagnosis of hyperperfusion syndrome after endovascular recanalization, and can be used to assess the therapeutic effect of vascular recanalization in followup. The indication function of TCD for non-invasive intracranial pressure monitoring needs an internationally accepted and repeatable mathematical model.

Key words: Transcranial Doppler; Intensive care; Cerebrovascular disease; Bedside mornitoring

米东华, 杨中华, 杨波, 王拥军, 刘丽萍. 床旁经颅多普勒在重症脑血管病监护中的应用[J]. 中国卒中杂志, 2018, 13(05): 521-526.

MI Dong-Hua, YANG Zhong-Hua, YANG Bo, WANG Yong-Jun, LIU Li-Ping. Application of Bedside Transcranial Doppler in Monitoring of Severe Cerebrovascular Diseases[J]. Chinese Journal of Stroke, 2018, 13(05): 521-526.

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