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严重脑外伤病人颅内压变化的测定可指导外科治疗,颅内压的监测手段多为颅内导管法(Richmond screw),而这种方法则为创伤性的,为明确透颅多普勒可否作为无创伤性连续监测颅内压的方法,我们用其连续测量大脑中动脉血流速度的变化,同时用导管法监测脑外伤病人的颅内压变化。我们连续每天监测病人共30名,监测期为3天到3周。颅内压高于20cmH2O为第一组,共20人,低于20cmH2O为第二组,共10人。在第一组病人中,大脑中动脉血流速度增加,其变化与颅内压的变化密切相关,而且血流速度的增加常在颅内压增高之前发生,同时脑血流速度波型的变化是判断脑死亡的一个重要指标。本研究说明,透颅多普勒在脑外伤监测中切实可行,在某些病例可取代颅内压测定。
Severe traumatic brain injury in patients with intracranial pressure changes can guide the surgical treatment of intracranial pressure monitoring means mostly intracranial catheter method (Richmond screw), and this method is traumatic, in order to clarify whether transcranial Doppler As a noninvasive continuous monitoring of intracranial pressure, we used it to continuously measure changes in blood flow velocity in the middle cerebral artery and monitored the changes in intracranial pressure in patients with traumatic brain injury by catheterization. We continuously monitor a total of 30 patients a day for a monitoring period of 3 days to 3 weeks. Intracranial pressure was higher than 20cmH2O for the first group, a total of 20 people, less than 20cmH2O for the second group, a total of 10 people. In the first group of patients, the middle cerebral artery blood flow velocity increased, its change is closely related to the change of intracranial pressure, and the increase of blood flow often occurs before the increase of intracranial pressure, and the change of cerebral blood flow velocity Is an important indicator of brain death. This study shows that transcranial Doppler in traumatic brain injury monitoring feasible, in some cases can replace the determination of intracranial pressure.