彩色多普勒超声对颈内静脉骨性压迫性狭窄所致脑鸣或耳鸣手术疗效的初步观察  

A preliminary study on the value of color Doppler ultrasound in evaluating the surgical efficacy of patients with tinnitus cerebri caused by bony compressive stenosis of the internal jugular vein

作　　者：刘旭东 杨敏[1] 褚桐苇 董健[2] 胡志强 吉训明 Liu Xudong;Yang Min;Chu Tongwei;Dong Jian;Hu Zhiqiang;Ji Xunming(Department of Ultrasonography,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Radiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Neurosurgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Capital Medical University Brain Disorders Research Center,Beijing Institute of Brain Disorders,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京世纪坛医院超声科,北京100038 [2]首都医科大学附属北京世纪坛医院放射科,北京100038 [3]首都医科大学附属北京世纪坛医院神经外科,北京100038 [4]首都医科大学脑重大疾病研究中心,北京脑重大疾病研究院,北京100069

出　　处：《中华神经外科杂志》2024年第7期708-711,共4页Chinese Journal of Neurosurgery

摘　　要：目的初步探讨彩色多普勒超声(CDU)对寰椎横突或茎突压迫所致颈内静脉(IJV)狭窄引起脑鸣或耳鸣患者的手术效果的评估价值。方法回顾性分析2020年9月至2023年3月于首都医科大学附属北京世纪坛医院神经外科收治的8例IJV狭窄所致脑鸣或耳鸣患者的临床资料。所有患者均经CT静脉成像(CTV)确诊,证实均存在因寰椎横突或茎突压迫导致的IJV狭窄。8例患者行寰椎横突或茎突部分磨除减压术后,于术前1周、术后1周内、术后3~6个月行CDU检查,分析IJV管径、平均血流量(FVm)和最大血流速度(Vmax)的变化。结果8例患者术后1周内的IJV各节段管径和FVm与术前的差异无统计学意义(均P>0.05)。术后3~6个月,IJV J1和J2段的管径较术前显著增加[J1段:(9.52±2.09)mm对比(7.45±2.10)mm;J2段:(6.75±1.74)mm对比(5.52±1.91)mm](均P<0.05),而IJV J3段与术前的差异无统计学意义(P>0.05);IJV各节段的FVm均较术前改善[J1段:(349.20±188.99)ml/min对比(204.60±118.50)ml/min;J2段:(193.10±91.32)ml/min对比(124.50±81.57)ml/min;J3段:(152.70±95.71)ml/min对比(61.90±53.23)ml/min](均P<0.05);IJV各节段的Vmax与术前的差异均无统计学意义(均P>0.05)。结论初步观察显示,寰椎横突或茎突部分磨除手术可改善IJV骨性压迫性狭窄所致脑鸣或耳鸣患者IJV狭窄段的管径及血流动力学,CDU可作为IJV骨性压迫性狭窄病变手术疗效的客观评估手段。Objective To investigate the evaluation of surgical efficacy of cranial tinnitus with internal jugular vein(IJV)compressed by transversal process or styloid process of atlas with color doppler ultrasound(CDU).Methods The clinical data of 8 patients with cranial tinnitus due to IJV stenosis admitted to the Department of Neurosurgery,Beijing Shijitan Hospital,Capital Medical University from September 2020 to March 2023 were analyzed retrospectively.All patients with IJV stenosis due to compression of transversal process or styloid process of atlas were confirmed by computer tomography venography(CTV).After the surgery of partial decompression of the transversal process or styloid process of atlas,CDU examinations were performed 1 week before surgery,within 1 week after surgery,and 3-6 months after surgery to observe the changes of the maximum diameter,the mean flow volume(FVm)and the maximum velocity(Vmax)of the IJV.Results There was no statistical significance in the diameter or FVm of each part of IJV in 8 patients within 1 week after surgery(all P>0.05).At 3-6 months post surgery,the maximum diameter of the IJV at J1 and J2 were increased significantly compared with before[J1:9.52±2.09 mm vs.7.45±2.10 mm,J2:6.75±1.74 mm vs.5.52±1.91 mm](both P<0.05),whereas the difference in J3 was not significant(P>0.05).The FVm of IJV was improved compared with before[J1:349.20±188.99 ml/min vs.204.60±118.50 ml/min,J2:193.10±91.32 ml/min vs.124.50±81.57 ml/min,J3:152.70±95.71 ml/min vs.61.90±53.23 ml/min)(all P<0.05).There was no statistical significance in the parameter of Vmax of IJV compared with before(P>0.05).Conclusions For patients of cranial tinnitus caused by IJV stenosis compressed by bone structure,the preliminary observation has indicated that the surgery of partial decompression of the transversal process or styloid process of atlas may improve the lumen and hemodynamics of the narrow part of IJV.CDU can be used as an objective method to evaluate the effect of surgical treatment of IJV stenosis compresse

关 键 词：颈静脉 减压术 外科 超声检查 多普勒 彩色 脑鸣 治疗结果 

分 类 号：R654.3[医药卫生—外科学] R445.1[医药卫生—临床医学]