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A clinical research of monitoring cerebral blood flow with laser doppler flowmetry in patients with severe traumatic brain injury
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 7
- DOI:
- 10.3760/j.issn:1001-2346.2007.07.003
- Key Word:
- 颅脑创伤;脑血管循环;激光多普勒血流监测法;自动调节
Abstract： 目的 探讨重型颅脑创伤患者伤后急性期脑血流变化规律.方法 利用激光多普勒脑血流仪(LDF)监测36例重型颅脑创伤患者急性期的局部脑血流(rCBF)及颅内压(ICP),通过观察rCBF的变化趋势及LDF值与脑灌注压(CPP)的相关系数r,分析rCBF的变化及脑血流自动调节功能.结果 在监测第一阶段(0-12h)16例(44%)为低灌注;在第二阶段(12-24h)9例(25%)为低灌注;在第三阶段(24h以后)6例(17%)为低灌注.随着时间的推移,局部脑血流灌注量呈逐渐上升趋势.将CPP与LDF值的相关系数r作为评价脑血流自动调节功能的指数,15例(42%)至少出现一次自动调节功能受损,其中GCS 3～5分11例,GCS 6～8分4例.结论 重型颅脑创伤患者在伤后急性期多发生低灌注,随着时间的推移,局部脑血流量逐渐上升.患者伤后多发生暂时性的脑血管调节功能受损,特重型颅脑创伤自动调节功能受损的发生率要高于重型颅脑创伤.
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