经颅多普勒超声对脑梗死早期患者的诊断价值探讨
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摘要
目的探讨经颅多普勒超声(TCD)对脑梗死早期患者的诊断价值。方法选取2016年1月至2018年10月北京市朝阳区双桥医院收治的42例脑梗死早期患者作为本次研究的对象,所有患者均接受TCD和CT检查。观察并比较TCD和CT检查的准确率;观察受检者的平均血流速度和异常率,以及缺血性病变的检测结果。结果本组42例患者,TCD检查确诊脑梗死39例(92.86%),明显高于CT检查的34例(80.95%),差异有统计学意义(P <0.05)。42例受检者中,23例受检者出现血流减慢,占受检者的54.8%,表现为脑动脉供血不足;11例受检者出现血流速度增快,占受检者的26.2%,大部分表现伴涡流和(或)血管杂音;4例受检者血流信号消失,占受检者的9.5%;另4例受检者的血流速正常,占受检者的9.5%。患者的异常率较高,为90.5%(38/42)。患者TCD检查结果中血管狭窄性病变以大脑中动脉损害最为严重,其次是大脑前动脉、后动脉和基底动脉。结论对脑梗死早期患者行TCD,能无创地为诊断和治疗提供实时动态的血流动力学资料,显示脑部血管阶段性流速的增高,准确反应脑动脉狭窄、痉挛及缺血情况。
Objective To investigate the diagnostic value of transcranial Doppler ultrasound(TCD)in patients with early cerebral infarction. Methods Forty-two patients with early cerebral infarction admitted to Shuangqiao Hospital of Chaoyang District,Beijing from January 2016 to October 2018 were enrolled. All patients underwent TCD and CT examination. The accuracy of TCD and CT were observed and compared. The average blood flow velocity and abnormal rate of the subject and the results of the detection of the ischemic lesion were observed. Results In this group of 42 patients,39 cases(92.86%)were diagnosed by TCD,which was significantly higher than 34 cases(80.95%). The difference was statistically significant(P<0.05). Among the 42 subjects,23 patients had slower blood flow,accounting for 54.8% of the subjects,which showed insufficient blood supply to the cerebral arteries;11 patients showed an increase in blood flow velocity,accounting for the subjects. 26.2%,most of the performance accompanied by eddy currents and(or)vascular murmur;4 cases of the subject's blood flow signal disappeared,accounting for 9.5% of the subject,the other 4 cases of the patient's blood flow rate is normal,accounting for the subject's 9.5%. The patient's abnormal rate was higher at 90.5%(38/42). In patients with TCD transcranial Doppler ultrasonography,vascular stenosis lesions were most severely damaged by the middle cerebral artery,followed by the anterior cerebral artery,posterior artery,and basilar artery. Conclusion TCD transcranial Doppler ultrasound in patients with early cerebral infarction can provide non-invasive real-time dynamic hemodynamic data for diagnosis and treatment,showing the increase of blood flow in the brain,accurately reflecting cerebral artery stenosis and stenosis.
Objective To investigate the diagnostic value of transcranial Doppler ultrasound(TCD)in patients with early cerebral infarction. Methods Forty-two patients with early cerebral infarction admitted to Shuangqiao Hospital of Chaoyang District,Beijing from January 2016 to October 2018 were enrolled. All patients underwent TCD and CT examination. The accuracy of TCD and CT were observed and compared. The average blood flow velocity and abnormal rate of the subject and the results of the detection of the ischemic lesion were observed. Results In this group of 42 patients,39 cases(92.86%)were diagnosed by TCD,which was significantly higher than 34 cases(80.95%). The difference was statistically significant(P<0.05). Among the 42 subjects,23 patients had slower blood flow,accounting for 54.8% of the subjects,which showed insufficient blood supply to the cerebral arteries;11 patients showed an increase in blood flow velocity,accounting for the subjects. 26.2%,most of the performance accompanied by eddy currents and(or)vascular murmur;4 cases of the subject's blood flow signal disappeared,accounting for 9.5% of the subject,the other 4 cases of the patient's blood flow rate is normal,accounting for the subject's 9.5%. The patient's abnormal rate was higher at 90.5%(38/42). In patients with TCD transcranial Doppler ultrasonography,vascular stenosis lesions were most severely damaged by the middle cerebral artery,followed by the anterior cerebral artery,posterior artery,and basilar artery. Conclusion TCD transcranial Doppler ultrasound in patients with early cerebral infarction can provide non-invasive real-time dynamic hemodynamic data for diagnosis and treatment,showing the increase of blood flow in the brain,accurately reflecting cerebral artery stenosis and stenosis.
引文
[1]姜学明.探讨经颅多普勒超声对脑梗死早期患者预后的评估价值分析[J].中国医疗器械信息,2017,23(5):56-58.
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[5]王飞.经颅多普勒超声在脑梗死患者脑血流检测中的价值研究[J].中国现代药物应用,2017,2(8):46-48.
[6]谢静.经颅多普勒血流动力学分型对大脑中动脉急性脑梗死患者预后的评估价值[J].海南医学院学报,2016,22(15):1741-1744.
[7]赵敏,段枫,雷霞,等.探讨经颅多普勒超声(TCD)对脑梗死早期患者的诊断价值[J].中国实用神经疾病杂志,2016,19(9):102-104.
[8]薛洁,耿献辉.经颅多普勒超声对缺血性脑卒中患者的诊断价值及临床意义[J].中国实用神经疾病杂志,2017,20(15):50-52.
[9]陈佳鸥,韩丽雅,黄向东.TCD在脑梗死患者颅内动脉狭窄中的诊断价值[J].现代实用医学,2016,28(7):965.
[10]宣正昊,张谦,李丽.TCD、PWV和ABI联合检测在脑卒中早期诊断中的应用效果观察[J].临床和实验医学杂志,2014,13(22):1853,1855.
[11]李增进.脑梗死早期诊断中经颅多普勒超声的运用探究[J].饮食保健,2018,5(25):8-9.
[2]吴斐,曹文杰,董强,等.经颅多普勒超声在急性脑卒中静脉溶栓患者中的应用[J].中国临床神经科学,2014,22(2):228-233.
[3]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[4]吴变歌,吴东阳.脑梗死患者经颅多普勒检查的诊断价值及临床意义[J].中国现代药物应用,2014,8(16):63-64.
[5]王飞.经颅多普勒超声在脑梗死患者脑血流检测中的价值研究[J].中国现代药物应用,2017,2(8):46-48.
[6]谢静.经颅多普勒血流动力学分型对大脑中动脉急性脑梗死患者预后的评估价值[J].海南医学院学报,2016,22(15):1741-1744.
[7]赵敏,段枫,雷霞,等.探讨经颅多普勒超声(TCD)对脑梗死早期患者的诊断价值[J].中国实用神经疾病杂志,2016,19(9):102-104.
[8]薛洁,耿献辉.经颅多普勒超声对缺血性脑卒中患者的诊断价值及临床意义[J].中国实用神经疾病杂志,2017,20(15):50-52.
[9]陈佳鸥,韩丽雅,黄向东.TCD在脑梗死患者颅内动脉狭窄中的诊断价值[J].现代实用医学,2016,28(7):965.
[10]宣正昊,张谦,李丽.TCD、PWV和ABI联合检测在脑卒中早期诊断中的应用效果观察[J].临床和实验医学杂志,2014,13(22):1853,1855.
[11]李增进.脑梗死早期诊断中经颅多普勒超声的运用探究[J].饮食保健,2018,5(25):8-9.