经颅多普勒超声早期预测动脉瘤夹闭术后迟发性脑缺血的临床分析

发布时间：2018-01-09 22:29

  本文关键词：经颅多普勒超声早期预测动脉瘤夹闭术后迟发性脑缺血的临床分析　出处：《山东大学学报(医学版)》2017年11期 　论文类型：期刊论文

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【摘要】：目的评价经颅多普勒超声(TCD)对破裂动脉瘤夹闭术后迟发性脑缺血(DCI)预测的敏感性,并初步探讨影响DCI的危险因素。方法回顾性分析67例破裂动脉瘤行开颅夹闭手术的患者临床资料,分别用ROC曲线和Logistic回归分析TCD对DCI的预测情况及影响DCI的危险因素。结果出现DCI 18例,发生率为26.9%;大脑中动脉平均血流速度(MCAVm)为149.5 cm/s时对DCI的预测准确性最高,其灵敏度和特异度分别为88.9%和81.6%;改良Fisher分级和MCAVm≥130 cm/s与DCI的发生有显著相关性。结论 TCD早期动态监测可有效预测动脉瘤夹闭术后DCI,是指导治疗和减少缺血性神经功能损害的有效手段,并对改善患者预后有重要临床意义,且改良Fisher分级和MCAVm≥130 cm/s是DCI发生的危险因素。
[Abstract]:Objective to evaluate the sensitivity of transcranial Doppler echocardiography (TCD) in predicting delayed cerebral ischemia (DCI) after ruptured aneurysm clipping. Methods the clinical data of 67 patients with ruptured aneurysms undergoing craniotomy were analyzed retrospectively. ROC curve and Logistic regression analysis were used to predict the DCI and the risk factors affecting DCI. Results 18 cases of DCI appeared, the incidence rate was 26.9%. The mean blood flow velocity of middle cerebral artery (MCAV m) was 149.5 cm/s and the accuracy of predicting DCI was the highest with sensitivity and specificity of 88.9% and 81.6, respectively. Improved Fisher grading and MCAVm 鈮，

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