去骨瓣减压术对高血压脑出血患者脑血流灌注的影响

发布时间：2018-03-25 17:07

本文选题：高血压脑出血　切入点：颅骨修补术　出处：《中国老年学杂志》2017年16期

【摘要】：目的研究高血压脑出血去骨瓣减压术后患者早期行颅骨修补术前后脑血流灌注的变化及意义。方法高血压脑出血行脑内血肿清除去骨瓣减压术后患者30例于行颅骨修补术前3d及术后14d行头部CT灌注成像检查以了解颅骨修补术前后患者脑血流灌注的变化,并由专人分别于颅骨修补术前及术后3个月行Barthel指数评定。结果术后全部患者临床症状有不同程度好转,颅骨修补术后Barthel指数评分较术前明显改善;术前手术侧大脑皮层、基底节区域脑血流量(rCBF)明显低于健侧,术后14d手术侧皮层rCBF较术前明显增加(P0.05),手术侧和健侧无明显差异。结论颅骨修补术可改善高血压脑出血去骨瓣减压术后患者手术侧皮层rCBF,进而有利于恢复患者神经功能。
[Abstract]:Objective to study the changes and significance of cerebral blood flow perfusion before and after cranioplasty in patients with hypertensive cerebral hemorrhage after decompression of craniotomy. Methods 30 patients with hypertensive intracerebral hemorrhage undergoing intracerebral hematoma clearance after decompression of cranium were treated with craniotomy. Ct perfusion imaging was performed 3 days before and 14 days after bone repair to understand the changes of cerebral blood perfusion before and after cranioplasty. The Barthel index was evaluated before and 3 months after cranioplasty. Results the clinical symptoms of all patients were improved in varying degrees, and the Barthel index score after cranioplasty was significantly improved. The regional cerebral blood flow (rCBF) in basal ganglia was significantly lower than that in healthy side. On the 14th day after operation, the cortical rCBF of the operative side increased significantly compared with that of the preoperative side, but there was no significant difference between the operative side and the normal side. Conclusion cranioplasty can improve the cortical cortex of the patients with hypertensive intracerebral hemorrhage after decompression of bone flap, and thus is beneficial to the recovery of the neurological function of the patients.
【作者单位】：唐山市工人医院神经外科;唐山市工人医院检验科;
【基金】：河北省2016年度医学科学研究重点课题(20160855)
【分类号】：R651.12

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