经颅多普勒联合血压动态监测在脑高灌注综合征中的应用  

Application of transcranial Doppler combined with dynamic blood pressure monitoring in cerebral hyperperfusion syndrome

作　　者：王魁花 许海珍 叶建新 林航 崔晓萍 WANG Kuihua;XU Haizhen;YE Jianxin;LIN Hang;CUI Xiaoping(The 900th Hospital of Joint Logistic Support Force/Fuzong Clinical Medical College of Fujian Medical University,Fuzhou 350025,China)

机构地区：[1]联勤保障部队第九〇〇医院福建医科大学福总临床医学院,福建福州350025

出　　处：《中国实用神经疾病杂志》2021年第16期1399-1407,共9页Chinese Journal of Practical Nervous Diseases

基　　金：院内医学科学技术研究计划(编号:2016L07)。

摘　　要：目的探讨经颅多普勒超声(TCD)联合血压动态监测在颈动脉狭窄支架置入术(CAS)后脑高灌注综合征(CHS)中的应用价值。方法选取联勤保障部队第九〇〇医院2017-01—2019-12前瞻性入组的247例CAS患者,根据随机数字法分为TCD+血压监测组117例和单纯血压监测组130例,TCD+血压监测组根据患者术前、术后的血流动力学指标进行血压调控,单纯血压监测组根据临床常规调控血压,比较2组术后高灌注综合征的发生率。结果TCD+血压监测组高灌注综合征发生率(0.87%)与单纯血压监测组(5.22%)相比,差异有统计学意义(P<0.01)。结论应用TCD联合血压动态监测能够有效识别并降低CHS的发生,对指导围手术期治疗及改善临床预后具有重要意义。Objective To investigate the value of transcranial Doppler ultrasonography(TCD)combined with dynamic monitoring of blood pressure in the treatment of cerebral hyperperfusion syndrome(CHS)after carot⁃id stenosis stenting(CAS).Methods A total of 247 CAS patients enrolled prospectively in our hospital from Janu⁃ary 2017 to December 2019 were selected.According to random number method,they were divided into the TCD+blood pressure monitoring group(117 cases)and the simple blood pressure monitoring group(130 cases).The TCD+blood pressure monitoring group was regulated according to the hemodynamic blood indexes before and after surgery.Blood pressure was regulated according to clinical routine in the simple blood pressure monitoring group and the incidence of postoperative hyperperfusion syndrome was compared between the two groups.Results The incidence of hyperperfusion syndrome in TCD+blood pressure monitoring group(0.87%)was significantly different from blood pressure monitoring group(5.22%),P<0.01.Conclusion Transcranial Doppler combined with dynamic blood pressure monitoring can effectively identify and reduce the occurrence of cerebral hyperperfusion syndrome,which is of great significance for guiding perioperative treatment and improving clinical prognosis.

关 键 词：脑高灌注综合征 颈动脉狭窄 支架置入术 经颅多普勒超声 血压 

分 类 号：R743[医药卫生—神经病学与精神病学]