经颅多普勒连续监测对颅内动脉瘤夹闭术后患者预后的影响  

Effect of continuous transcranial Doppler monitoring on the prognosis of patients after intracranial aneurysm clipping

作　　者：刘明泽 许川徽 王业忠 颜红波[1] 龙斌[1] LIU Mingze;XU Chuanhui;WANG Yezhong;YAN Hongbo;LONG Bin(Department of Neurosurgery,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong,510000,China)

机构地区：[1]广州医科大学附属第二医院神经外科,广东广州510000

出　　处：《当代医学》2022年第21期138-140,共3页Contemporary Medicine

摘　　要：目的 探讨经颅多普勒(TCD)连续监测对颅内动脉瘤夹闭术后患者预后的影响。方法 选取2019年1月至2020年6月于本院行颅内动脉瘤夹闭术治疗的60例颅内动脉瘤患者作为研究对象,按照术后是否接受TCD连续监测分为观察组和对照组,各30例。观察组术前、术后根据TCD连续监测情况,增加使用及动态调整钙拮抗剂用量,对照组仅在术前行TCD监测。比较两组术后肌力分级、出院时及出院后3个月格拉斯哥预后评分(GOS)。结果 出院时,两组肌力分级比较差异无统计学意义;出院时,两组GOS评分比较差异无统计学意义;出院后3个月,观察组GOS评分5分占比高于对照组,差异有统计学意义(P<0.05)。结论 动脉瘤夹闭术后使用TCD连续监测脑血流动力学变化可以在出现临床症状或严重并发症前及时有效地发现脑血流改变,指导临床医生及时干预,改善患者预后。Objective To investigate the effect of transcranial Doppler monitoring on the prognosis of patients after intracranial aneurysm clipping. Methods A total of 60 patients with intracranial aneurysm who received clipping surgery in our hospital from January 2019 to June 2020were selected as the study subjects, and they were divided into observation group and control group according to whether they received continuous transcranial Doppler examination after surgery, with 30 cases in each group. The dosage of calcium antagonist was in the observation group increased according to the condition of transcranial Doppler ultrasonography before and after surgery, while the control group was only monitored by transcranial Doppler ultrasonography before surgery. The postoperative muscle strength classification, the Glasgow outcome score(GOS) at postoperative discharge and 3 months after discharge were compared between the two groups. Results At discharge, there was no significant difference in muscle strength classification between the two groups;at discharge, there was no significant difference in GOS between the two groups;3 months after discharge, the proportion of GOS score 5 in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Continuous dynamic monitoring of cerebral hemodynamics after aneurysm clipping by transcranial Doppler can effectively detect changes in cerebral blood flow before clinical symptoms or serious complications, guide clinicians to intervene in time and improve the prognosis of patients.

关 键 词：颅内动脉瘤夹闭术 经颅多普勒 格拉斯哥预后评分 肌力 

分 类 号：R651.12[医药卫生—外科学]