摘要
目的利用彩色多普勒超声研究颈动脉交感神经网切除及迷走神经孤立术(以下简称为改良颈动脉交感神经网切除术)对混合型脑瘫患儿颈动脉血液动力学的影响。方法选择自2019年6月至2021年7月于暨南大学崇爱医院脑瘫治疗中心实施改良颈动脉交感神经网切除术的30例混合型脑瘫患儿为研究对象,均于术前2 d和术后9 d做颈动脉彩超。自身对照分析术前和术后的颈动脉彩超指标,包括:颈动脉的内径、动脉收缩期最大流速(PSV)、动脉收缩末期的峰值与舒张末期的峰值的比值(S/D)、动脉舒张末期的流速(EDV)、阻力指数(RI)。结果30例混合型脑瘫患儿术后双侧颈动脉PSV、EDV均高于术前,双侧S/D明显小于术前,左侧RI低于术前,差异均具有统计学意义(P<0.05);右侧RI低于术前,但差异均无统计学意义(P>0.05);双侧动脉内径变化差异均无统计学意义(P>0.05)。术后1个月,本组患儿中5例流涎明显减少,26例认知能力和注意力改善,14例讲话不清改善,21例运动功能提高,3例咀嚼吞咽功能改善,总改善率为79.7%。结论行改良颈动脉交感神经网切除术后,混合型脑瘫患儿的颈动脉血流速度明显加快,提示脑瘫受损的脑组织在血供改善的基础上得到不同程度的修复和代偿,从而改善患儿的临床症状。
Objective To investigate the changes of carotid hemodynamics in children with mixed cerebral palsy with carotid sympathetic nerve network resection and vagal nerve isolation (referred to as modified carotid sympathectomy) by color Doppler ultrasound.Methods From June 2019 to July 2021, 30 children with mixed cerebral palsy who underwent modified carotid sympathectomy at the Cerebral Palsy Treatment Center of Chongai Hospital of Jinan University were selected, carotid color ultrasound was performed 2 d before and 9 d after the operation. The preoperative and postoperative carotid artery color Doppler ultrasound indexes were compared with self-contrasted method, including: Carotid artery diameter and Peak systolic velocity (PSV), end diastolic velocity (EDV), systolic to diastolic ratio (S/D), resistance index (RI).Results The PSV and EDV of bilateral carotid arteries in 30 children with mixed cerebral palsy after operation were higher than those before operation, the S/D was significantly lower than that before operation, and the RI of left side was lower than that before operation, The differences were statistically significant (P<0.05). RI on the right side was lower than that before operation, but the difference was not statistically significant (P>0.05). There was no significant difference in the diameter of bilateral arteries (P>0.05). One month after operation, 5 children in this group had a significant reduction in salivation, 26 had improvement in cognitive ability and attention, 14 had improvement in unclear speech, 21 had improvement in motor function, and 3 had improvement in chewing and swallowing function. The overall improvement rate was 79.7%.Conclusion After the modified carotid sympathectomy, the carotid blood flow velocity of children with mixed cerebral palsy was significantly accelerated, indicating that the damaged brain tissue of cerebral palsy was repaired and compensated to varying degrees on the basis of improved blood supply, thereby improving the clinical symptoms of children.
作者
陈鸿耀
曾凡华
马立萍
江远舟
李理想
Chen Hongyao;Zeng Fanhua;Ma Liping;Jiang Yuanzhou;Li Lixiang(Cerebral Palsy Treatment Center,Chongai Hospital of Jinan University,Guangzhou 510030,China;Department of Ultrasound Medicine,Chongai Hospital of Jinan University,Guangzhou 510030,China)
出处
《中华脑科疾病与康复杂志（电子版）》
2022年第5期302-305,共4页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
关键词
混合型脑瘫
彩色多普勒超声
颈动脉
交感神经网
迷走神经
Mixed cerebral palsy
Doppler color vascular ultrasound
Cartic artery
Sympathetic neural networt
Vagus
