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术中微血管多普勒超声在颅内动脉瘤手术中的初步应用
影响颅内动脉瘤手术预后的因素较多,除取决于患者的病情外,手术方法也是重要的影响因素.我们在近期颅内动脉瘤手术中采用了微血管多普勒超声(microvascular Doppler ultrasonography,MDU)进行术中监测,以期探讨术中MDU对颅内动脉瘤手术的影响和意义.
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应用颈动脉超声分析缺血性脑血管病危险因素与颈动脉斑块的关系
缺血性脑血管病是中老年患者常见病,颈动脉粥样硬化斑块则是其常见的致病原因之一,可用其反映全身动脉粥样硬化的程度[1].颈动脉双功能超声具有安全、无创、简便易行及直观准确的特点,在临床得到广泛应用.作者对642例缺血性脑血管病患者进行了颈动脉超声检查,以探讨颈动脉斑块与高血压、糖尿病、血脂异常、白细胞增高等动脉硬化危险因素的关系,以及与脑梗死发生、发展的相互关系.
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脑血流频谱原理分析在经颅多普勒超声诊断中的应用
在经颅多普勒超声(transcranial Doppler ultrasonography,TCD)诊断中,对血流动力学的改变,除了要观察血流速度、血流转流、侧支循环、血流方向和血管杂音等之外,还要特别注意频谱形态的变化,它经常包含着丰富的血流动力学信息.分析频谱形态的改变及其形成原理,有助于更深入了解脑血管病变的机制.
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超声技术在医学上的四大应用
随着科学技术的发展,医学界越来越认识到超声技术在医学上广泛的前景。现就4个有代表性的方面谈谈这一问题。1 颅脑超声检测颅脑超声检测诊断技术目前包括两大类。经颅频谱多普勒(transcranial Doppler ultrasonographyTCD)技术自1982年Aaslid创立以来,已有近18年的历史。
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经颅多普勒超声诊断要点
1982年,挪威物理学家鲁恩·艾期里德(Rune Aaslid)创立了经颅多普勒超声(transcranial Doppler ultrasonography,TCD)技术,他与德国EME公司共同开发出世界第一台经颅多普勒超声诊断仪,并应用于临床,提供了无创性检测颅内血流动力学和诊断脑血管疾病的新方法.TCD技术具有操作简便、快速、无创伤、无射线辐射、重复性好、实用性强等特点,深受临床欢迎.
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经颅多普勒超声检查诊断要点
1982年,挪威物理学家鲁恩·艾斯里德创立了经颅多普勒超声(Transcranial Doppler Ultrasonography,TCD)技术,他与德国EME公司共同开发出世界第一台经颅多普勒超声诊断仪,并应用于临床,提供了无创性检测颅内血流动力学和诊断脑血管疾病的新方法.技术具有操作简便、快速、无创伤、无射线辐射、重复性好、实用性强等特点,深受临床欢迎.近10年来,技术在基础研究,仪器更新,检测技术及临床应用等方面都有显著的发展.
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经颅多普勒超声诊断要点
[编者按]根据读者要求,将"经颅多普勒超声诊断要点"重新刊登,供读者参考.1982年,挪威物理学家鲁恩·艾斯里德(Rune Aaslid)创立了经颅多普勒超声(transcranial Doppler ultrasonography,TCD)技术,他与德国EME公司共同开发出世界第一台经颅多普勒超声诊断仪,并应用于临床,提供了无创性检测颅内血流动力学和诊断脑血强等特点,深受临床欢迎.近10年来,TCD技术在基础研究,仪器更新,检测技术及临床应用等方面都有显著的发展.1987年我国引进TCD诊断仪,开辟了我国超声技术临床应用的新领域,并迅速发展,不断更新.在短短近10年中,在临床科研方面取得了可喜的成就.实践证明TCD已成为现代医学影像技术的组成部分和研究脑血流生理学与病理生理状态下血流动力学变化的重要手段.
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功能性经颅多普勒超声的研究进展
经颅多普勒超声(TCD)是一种具有实时性的无创的诊断工具,它可连续同时监测双侧的脑血流速度(CBFV),TCD结合彩色多普勒能量图或磁共振血管成像技术可无创地测量大脑血流量[1].功能性经颅多普勒超声(functional transcranial Doppler ultrasonography,fTCD)是研究认知活动时双侧半球不同动脉血流速度变化的技术.本文对有关fTCD的研究做一综述.
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彩色多普勒超声诊断小腿深静脉血栓的体会
随着彩色多普勒超声(color Doppler ultrasonography,CDUS)在下肢血管疾病诊断中的广泛应用,该检测方法为临床对血管疾病的诊断和治疗提供了大量的参考依据.本研究通过对38例小腿深静脉血栓患者临床及超声特点的分析,旨在总结经验,提高超声检查对小腿深静脉血栓的检出和诊断能力.
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Objective: To evaluate the effect and safety of early moderate hypothermia therapy (MHT) on patients with head injury by using parallel-control test. Methods: Thirty patients with severe head injury within 6 hours after accidents were treated by MHT generally for 4-10 days. The other 30 patients with similar head injury treated routinely were enrolled for a parallel-control test. The mortality, morbidity and changes of some neuro-functional indexes as Glasgow Coma Scores, and Glasgow Outcome Scale, levels of endothelin and some other factors of neurobiochemistry in blood plasma were observed. Meanwhile, the dynamic monitoring by transcranial Doppler ultrasonography was conducted in these patients. Results: The mortality in MHT group was significantly lower than that in control group. MHT not only reduced endothelin but also increased the brain biochemical factors, which were helpful to the protection of neurons in the early brain ischemia after head injury. Conclusions: Early MHT can help reduce mortality and morbidity in patients with acute head injury.
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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.