经颅三维多普勒检测脑震荡患者脑血流演变的特点规律研究

目的探讨脑震荡所致的脑血管痉挛发生机制和尼莫地平治疗脑震荡作用。方法224例脑震荡患者随机分成尼莫地平组(113例)和对照组(111例)应用经颅三维多谱勒(3D-TCD)检测大脑中动脉(MCA),基底动脉(BA)脑血流平均峰流速度,分析脑血流变化规律、特点。结果脑震荡脑血流分为脑血流低灌扩张期、脑血管痉挛期、脑血流恢复期。尼莫地平组在脑血管痉挛期和恢复期临床主要症状消失率明显优于对照组,有非常显著差异(P<0.01)。结论脑血管痉挛和脑缺氧、缺血损害是脑震荡主要病理改变之一,脑神经功能障碍是否可逆,主要取决于脑血管痉挛持续时间长短。

Detection of changes in cerebral blood flow by color three dimensional transcranial doppler in patients with concussion

Objective Discussing the mechanism of cerebral spasma caused by concussion and the effect on concussion by using nimoldipine.Method 224 cases were divided into two groups randomly,Nimoldipine group (113 cases) and control group(111 cases). Median cerebral artery (MCA), base artery (BA) and the average peak forward velocity of cerebral blood flow were measured by color three dimensional trancranial doppler (3D TCD). Cerebral blood flow changing regularity,characteristic and treatment effect were analysed. Result Concussion cerebral blood flow was divided into cerebral blood folw low infusion dilate phase, cerebral blood vessel spasma phase,cervebral blood flow recovery phase. In Nimoldipine group clinical main symptom disappearing rate was better than control group significantly in cerbral spasma phase and necovery phrase,the difference was obvious,P< 0.01. Conclusion Cerebral vessel spasma,hypoxia and ischemia lesion is one of the main pathological change. Whether cerebral nerve dysfunction is reversible or not is mainly determinded by spasma time of cerebral blood vessel.