小脑顶核电刺激对脑外伤患者脑血流速度和颅内压的影响  

The effects of fastigial nucleus stimulation on cerebral blood flow velocity and intracranial pressure of patients with brain injury

作　　者：杨波[1] 关方霞[1] 张强[2] 宋来君[1] 刘书君 陈喜中 赵建英 鲁国军 张正勇 李丽 

机构地区：[1]河南医科大学一附院神经外科,河南郑州450052 [2]河南医科大学97级研究生班,河南郑州450052 [3]新郑市人民医院,河南新郑451150

出　　处：《中风与神经疾病杂志》2000年第3期147-148,共2页Journal of Apoplexy and Nervous Diseases

基　　金：河南省科委科技攻关项目!( 981170 3 3 9)

摘　　要：目的　探讨小脑顶核电刺激对脑外伤患者脑血流速度和颅内压的影响。方法　选择 2 0例脑外伤患者 ,其中 7例行手术治疗。用小脑顶核电刺激方法对所有患者实施电刺激 ,应用经颅多普勒超声技术检测刺激前后大脑前、中、后动脉 (ACA ,MCA,PCA)血流速度。通过颅内压监护持续监测刺激前后颅内压的变化。结果　实施刺激后 10分钟 ,脑血流速度升高 ,2 0～ 30分钟达高峰。刺激前 ACA,MCA,PCA血流速度分别为 45 .5± 8.3cm/ s,5 3.6± 10 .2 cm / s和 36 .9± 8.4cm / s;刺激后分别为 6 0 .2± 9.6 cm/ s,6 7.2± 11.7cm/ s和 37.2± 8.6 cm/ s;ACA和MCA的血流速度在刺激后明显升高 (P <0 .0 5 )。 7例脑外伤患者小脑顶核电刺激前后颅内压无明显变化 (P>0 .0 5 )。结论　小脑顶核电刺激后可明显提高脑外伤患者颅内血流速度 ,改善脑循环 ,对颅内压变化无明显影响。Objective To explore the effects of fastigial nucleus stimulation on cerebral blood flow velocity and intracranial pressure of patients with brain injury. Methods 20 patients with brain injury were studied,7 of them were treated by operation.All the patients were stimulated by fastigial nucleus stimulation (FNS). The blood flow velocities of anterior cerebral artery (ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA) were measured by transcranial Doppler (TCD) ultrasound. Intracranial pressure(ICP) monitoring was performed on 7 of 20 patients. The TCD evaluation and ICP monitoring were carried out before and after stimulation. Results The cerebral blood velocity began to rise in 10 minutes after stimulation and arrived at summit in 20～30 minutes. The blood flow velocities of ACA,MCA and PCA were 45.5±8.3cm/s,53.6±10.2cm/s and 36.9±8.4cm/s separately before stimulation;They became 60.2±9.6cm/s,67.2±11.7cm/s and 37.2±8.6cm/s after stimulation. The velocities of ACA and MCA obviously increased after stimulation(P<0.05). The ICP of 7 patients had no change before and after stimulation(P>0.05). Conclusion The FNS can increase cerebral blood velocity of patient with brain injury obviously and does not effect on ICP.

关 键 词：小脑顶核 脑血流速度 颅内压 颅脑外伤 

分 类 号：R651.15[医药卫生—外科学]