血管超声检查对颈动脉内膜剥脱诊断的应用价值  

The clinical value of color Doppler in carotid endarterectomy

作　　者：夏凯[1] 彭涛[2] 段云古[1] 陈清山[1] 

机构地区：[1]泰山医学院附属聊城市第二人民医院神经外科,山东省临清252600 [2]泰山医学院附属聊城市第二人民医院超声科,山东省临清252600

出　　处：《中国基层医药》2016年第8期1158-1160,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨血管超声在颈动脉内膜剥脱患者诊断中的应用价值。方法回顾性分析45例颈动脉内膜剥脱患者的资料和彩色多普勒超声、经颅多普勒超声检查结果，术前CDFI明确颈动脉狭窄程度、斑块性质，TCD评估侧枝循环代偿情况，TCD术中监测大脑中动脉血流指导是否转流、有无过度灌注，CDFI检查缝合后管腔通畅情况及有无内膜游离，术后CDFI随访了解管腔通畅情况及有无内膜增生再狭窄。结果45例患者术前超声均提示颈内动脉重度狭窄，低回声斑块17例，强回声斑块12例，不均质回声斑块16例，侧枝循环良好者31例，侧枝循环代偿不良术中需转流者14例，45例患者颈动脉内剥脱后，狭窄处颈动脉的内径恢复、颅内灌注较术前明显改善；术后随访疗效满意，管腔通畅，未见再狭窄情况发生。结论颈动脉内膜剥脱是治疗颈动脉狭窄安全有效的方法，血管超声能够为颈动脉内膜剥脱患者提供术前准确评估、术中安全监测、术后有效随访。Objective To study the clinical value of color Doppler ultrasound in carotid endarterectomy （ CEA） .Methods Forty-five patients with CEA were examined and analyzed by TCD and CDFI.The position, range,character,diameter,stenosis rate were measured by CDFI and collateral flow by TCD before CEA.The intraop-erative CDFI was applied to confirm the flow and the flaps in carotid artery.TCD monitoring of middle cerebral blood flow in CEA to assess whether use shunt technique and cerebral hyper-perfusion.CDFI was applied to assess patency and intimal hyperplasia of carotid artery.Results Seventeen low echo plaques,twelve high echo plaques and sixteen hypoechogenicity echo plaques in forty-five patients with internal carotid stenosis were found by color Doppler ultra-sound.Blood flow volume increased significantly in the ispilateal internal carotid arteries and middle cerebral arteris after operation.Carotid artery restenosis was not found by color Doppler ultrasound after CEA.Conclusion Applica-tion of color Doppler in CEA is valuable in the diagnosis of internal carotid stenosis,intraoperative monitoring and in the evaluation of effect.

关 键 词：血管超声 颈动脉内膜剥脱 颈动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]