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持续经颅多普勒监测对丹参注射液药物作用的影响
持续经颅多普勒超声监测(continuous transcranial Doppler monitoring,CTDM)不仅能用于脑血管疾病的诊断、监护,还对一些药物的疗效产生影响,国外已经开展了相关的动物实验和临床研究,但国内尚未见到这方面的研究报道.丹参注射液具有活血化瘀通脉的功效,是治疗脑动脉硬化、脑梗塞及脑动脉狭窄的临床常用药物,本研究采用病例对照的方法观察了持续经颅多普勒监测对丹参注射液药物作用的影响.
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经颅多普勒超声操作规范及诊断标准指南
一、概述经颅多普勒超声(transcranial Doppler,TCD)是利用人类颅骨自然薄弱的部位作为检测声窗(如颞骨嶙部、枕骨大孔、眼眶),对颅底动脉血流动力学进行评价的一种无创性检查方法.
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经颅多谱勒对高血压和糖尿病患者血管功能的评估
Background:Hypertension and diabetes are independent and main risk factors of cerebral vascular lesion.These two diseases can interact and aggravate cerebral vascular lesion when they exist together.We can know lesion characteristics and hemodynamics change by transcranial Doppler (TCD).We examed 186 hypertension and diabetes cases by TCD,and compared their result.
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经颅多普勒与脑电图对成人与儿童血管性头痛特征分析
INTRODUCTION The headache of common nature as well as headachic epilepsy and hemicrania pianheadache often affects the children.Hemicrania is the result of mental and vascular disorder,which is examined with transcranial Doppler(TCD) and electroencephalography(EEG).In this study,we analyzed the characteristics of vascular headache of children compared with adults.
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经颅三维多普勒技术对脑震诊断、疗效及愈后的评估
Objective In order to offer a noninvasive and objective examination method for assessing the clinical diagnosis and eurative criterion of concussion patients, the patients color three - dimensional transcranial doppler( 3D - TCD) characteristic at deferent phases, parameter and clincal manifestation were studied Method Parameter of Median Cerebral Artery(MCA), Base Artery(BA), the average peak forwand velocity of cerebral blood flow, train figure were tested by 3D - TCD within 24 hours, 3 - 6 days and at the end of treatment, respectively. The results were compared with clinical diagnoses and curative criterion. Result Among 135 patients who had clinically diagnosed concussion, agreeable diagnoses 101 cases, basically agreeable diagnooses 12 cases, disagreeable diagnosis 22 cases(16. 2%) .At the end of treatment, according to clinical determination 96 cases(71.1%) were cured, 39 cases(28.9%) were improved. Wave train character, figure and diagnoses prameter of cerebral spasm caused by concussion were suggested Conclusion To be one of the diagnostic bases and curative criterion, 3D- TC D technology is performable. Meanwhile, it is a new testing objective technique for assessing curative and determining prognosis.
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经颅多普勒超声在脑死亡判断中的频谱逆转现象
经颅多普勒超声(TCD)以血流频谱形态及血流指数的变化来诊断脑死亡.近年,国外大量的研究证实其对脑死亡的确诊有很高的应用价值[1],有些国家已把此项技术作为诊断脑死亡的检测手段之一[2].颅内血流停止时TCD的特征性表现为:第1阶段振荡波,第2阶段钉子波,第3阶段血流信号完全消失[1].在对临床拟诊为脑死亡的患者进行TCD检查过程中,发现了一种以往尚无报道过的现象:即在间隔12h后TCD检测结果由脑死亡特征性频谱逆转为不符合脑死亡诊断标准的频谱,现报告如下.
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经颅多普勒发泡实验对卵圆孔未闭的诊断价值
卵圆孔未闭(patentforamenovale,PFO)是房间隔的一种先天发育缺损。人群中约有1/4存在PFO [1]。一般情况下,卵圆孔未闭不引起心房间分流,不需外科手术,但近年来发现卵圆孔未闭引起反常栓塞机制与缺血性脑卒中的发生密切相关,卵圆孔未闭可导致脑栓塞的病因也渐有报告,两者之间有着重要的关联,尤其是小于55岁的青年卒中。PFO与隐源性缺血性脑卒中有着密切的关系,PFO可作为来自静脉循环"反常性栓子"的通道导致脑梗死[2]。常用的PFO的检测方法有经胸超声心动图(TTE)、经食道超声心动图(TEE)以及经颅多普勒超声微泡实验(contrast enhanced transcranial Doppler, c-TCD)3种检查。经食管超声心动图TEE是目前PFO诊断金标准,但TEE为侵人性操作,限制了其应用。近来的研究表明,c-TCD可作为PFO的无创筛查手段,它具有无创、简单、易行等优点。随着技术的完善,此种方法被认为可替代TEE[3]。本综述探讨c-TCD微泡实验的方法及对PFO的诊断作用价值。
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Objective: To investigate the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severe traumatic brain injury and to correlate the TCD values with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. Methods: A prospective study was conducted to evaluate the contribution of TCD ultrasonography to neurological outcome in a series of 96 severe traumatic brain injury patients. The quantitative variables of TCD ultrasonography included the mean blood flow velocity of the middle cerebral artery (MCA) and pulsatility index within the first 24 hours of admission. The ICP and CPP values were also recorded. Outcome in 6 months postinjury was evaluated using the Glasgow Outcome Scale (GOS 4-5 was considered as “good” and GOS 1-3 as “poor”). Results: The mean blood flow velocity of the MCA was larger than 40 cm/s in 30 (51%) patients with good outcome whereas it was less than 40 cm/s in 27 (73%) patients with poor outcome (P<0.025). The mean PI in cases of good outcome (34 patients, 57%) was lower than 1.5 whereas in poor outcome (30 patients, 83%) was higher than 1.5 (P<0.001). The correlations of ICP and CPP to pulsatility index were statistically significant (P<0.01). Conclusions: TCD ultrasonography is valid in predicting the patients outcome of 6 months and correlates significantly with ICP and CPP values when it is performed in the first 24 hours of severe traumatic brain injury.