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目的研究脑出血血肿周边脑血流量的经时变化特点,分析其动态变化规律。方法对幕上出血的21例患者分别于发病后不同时间点(24 h 及7、14、21、28 d)进行 Xe-CT 检查,采用感兴趣区测定血肿巾心区、周边缺血区及其镜像区的局部腑血流量。结果血肿周边局部脑血流量在发病24 h 下降不明显(17.5%),7 d 时出现明显下降(34.2%),在14 d 降至最低(48.5%),在21 d 时有所恢复(40.5%),在28 d 时仍持续低灌注状态(38.5%)。各时间点与24 h 对比,差异具有统计学意义。结论脑出血急性期血肿周边存在脑血流量的下降,缺血程度在24 h 较轻,然后逐渐加重,至发病14 d 达到高峰,3周后缺血逐渐减轻,血肿周围的低灌注区可持续3～4周以上。
Objective To study the characteristics of the changes of cerebral blood flow around the hematoma of the intracerebral hemorrhage over time, and analyze its dynamic changes. Methods Twenty-one patients with supratentorial hemorrhage were examined by Xe-CT at different time points (24 h, 7, 14, 21, 28 d) after onset. The area of interest The mirror area of the local organs blood flow. Results Local cerebral blood flow around the hematoma was not significantly decreased at 24 h (17.5%), decreased significantly at 7 d (34.2%), decreased to the lowest at 14 d (48.5%) and recovered at 21 d (40.5 %), And remained low perfusion state (38.5%) on the 28th day. Compared with 24 h at each time point, the difference was statistically significant. Conclusions Cerebral blood flow declines around the hematoma in the acute stage of cerebral hemorrhage. The degree of ischemia is lighter at 24 hours and then gradually aggravates until reaching the peak on the 14th day. The ischemic lesion gradually decreases after 3 weeks, and the hypoperfusion area around the hematoma is sustainable 3 to 4 weeks or more.