摘要
目的:研究GAVM周边rCBF术中变化。方法:8例GAVM术中行LDF监测。结果:GAVM切除后,周边LDF值上升(223.48±22.06)%(P＜0.001),并维持于高平台平均(69.64±11.25)min。5例LDF值升幅超过200%,其中4例发生脑过度灌注(P＜0.01)。术中静脉注射硫苯妥钠使LDF值下降(31.05±8.27)%(P＜0.01)。结论:①GAVM切除后,周边rCBF值显著上升。②GAVM术中LDF监测有助预测脑过度灌注。③应用短效巴比妥类药物,系统降压,可缓解脑过度灌注。④病灶周边麻痹性扩张的微血管床短时内不能恢复自动调节功能。
Aim: The intraoperative continuous adjacent rCBF alterations were evaluated in patients with giant arteriovenous malformations(GAVM). Methods: We analyzed the result of intraoperative continuous rCBF monitoring with laser-Doppler flowmetry (LDF) of 8 patients with GAVMs(φ>6 cm). Results: After the excision of the nidus, the increasing amplitudes of the LDF value were 223. 48±2. 06% (P< 0. 001) and the LDF curves hold at high level (the time duration was 69. 6±1. 25 min). 4 cases developed luxury perfusion syndromes, whose increasing amplitudes of LDF were all larger than 200%(P<0. 001). Following the intravenous infusion of Thiopentolim Natricum, the LDF value reduced (31. 05±. 27%, P< 0.01). Conclusions ①After the excision of the nidus, the rCBF value of LDF increased obviously, which proved the theory of luxury perfusion. ②The continuous evaluation of rCBF intraoperatively with LDF might do great help to predict the possibility of occurrence of luxury perfusion syndrome. ③The interval use of fugitive barbiturate agent-Thiopentolim Natricum, under the 'real time' rCBF monitoring by LDF, mightmaintain the controlled hypotension and cure the luxury perfusion syndrome. ④The paralytic dilated micro-vessel bed could not restore the ability of autoregulation in short time duration.
出处
《中国临床神经科学》
1999年第2期83-86,共4页
Chinese Journal of Clinical Neurosciences
基金
本课题为"九五"国家科技攻关项目(96-906-02-24)
关键词
脑动静脉畸形
脑过度灌注
血流测定
激光
超声波
arteriovenous malformations luxury perfusion laser-Doppler flowmetry thiopentolim natricum controlled hypotension
