摘要
目的 用无创方法检测颈动脉阻断 (CAO)时脑的耐受性。方法 对 16例患者在暂时性或永久性CAO前行压颈试验 ,并用经颅多普勒 (TCD)、局部脑氧饱和度 (rSO2 )和体感诱发电位 (SEP)进行监测。结果 本组均无神经系统并发症出现。CAO后 ,同侧大脑中动脉和大脑前动脉平均血流速度 (mV)下降 (33.73± 14.45 ) %和翻转为正向 (2 7.6 9± 2 3.15 )cm/s ;rSO2 下降 (5 .18± 1.91) % ;SEP波幅下降均在 5 0 %以内。rSO2 下降与mV下降率间呈正相关 (r =0 .89,P =0 .0 0 0 1)。压颈和阻断时测得结果差异无显著性。结论 当mV下降大于 70 %、rSO2 减小超过 10 %或SEP波幅变化大于 5 0 %时 ,行CAO有潜在危险。
Objective To predict the tolerability of brain tissue to carotid artery occlusion (CAO) using noninvasive methods. Methods Matas maneuver combined with transcranial Doppler ultrasonography (TCD), regional cerebral oxygen (rSO 2) saturation and somatosensory evoked potentials (SSEPs) monitoring was performed in 16 patients prior to temporary or permanent CAO.Results There was no neurological deficit during CAO in all the cases. After occlusion, the mean velocity (mV) of ipsilateral MCA and ACA reduced (33.73±14.45)% (range, 12.58% to 56.16%) and reversed to (27.69±23.15) cm/s respectively. The rSO 2 decreased (5.18±1.91)%(range, 2% to 9%). No more than 50% attenuation of SSEPs was present. There was a linear correlation between rSO 2 fall and percent change in mV of ipsilateral MCA (r=0.89, P =0.0001). No significant difference was seen between the manual compression and the occlusion.Conclusion Decreases by more than 70% in mV, 10% in rSO 2 or 50% in SSEPs amplitude were evidences for intolerance to CAO.(Shanghai Med J, 2000,23∶199 201)
出处
《上海医学》
CAS
CSCD
北大核心
2000年第4期199-201,共3页
Shanghai Medical Journal
关键词
经颅多普勒
体感诱发电位
无创检测
颈动脉阻断
Carotid artery
Transcranial Doppler
Regional cerebral oxygen
Somatosensory evoked potentials
