摘要
目的 评估自发性脑出血急性期甘露醇的血流动力学作用。方法 据颅脑CT将患者分为小量 (<2 5ml)与大量出血 (>2 5ml)两组 ,用TCD动态监测用甘露醇前后MCA的变化。结果 小量出血组的Vm、Vd、PI值无变化 (P >0 .0 5 ) ;大量出血组用甘露醇后 15～ 4 5min内Vm、Vd 升高 ,PI降低 (P <0 .0 5 ) ,4 5～ 90min均恢复。后者的Vm、Vd 低于前者 (P <0 .0 5 ) ,而PI值相反。结论 观察发现小量出血组使用甘露醇后一般不影响脑循环供血与颅内压 ;而大量出血组输注甘露醇后 ,在短时间内脑血流量增多 ,颅内压降低 。
Objective To evaluate the early hemodynamic effects of manniol infusion in patients with acute spontaneous intracerebral hemorrhage(SICH).Methods On the basis of hematoma volumes, patients were divided into two groups. TCD was used to detect the hemodynamical changes of MCA. Hematoma volumes were calculated from admission CT scans and were compared with V m? V d and PI. TCD variables were recorded before and after mannitol infusion. Results The ipsilateral V m? V d and PI of the small sized SICH(<25?ml) were not changed ( P > 0.05 ). However, The V m? V d of the large sized SICH(>25?ml) increased while PI decreased at 45?min( P < 0.05 ). Then the V m? V d and PI were reversed during 45～90?min. Compared with patients with small hemorrhage, the large hemorrhage group had lower V m? V d but higher PI.Conclusion This study indicates that mannitol infusion does not effect the early hemodynamics and intracerebral pressure of the patient with small sized SICH. While the cerebral blood flow of the patients with large hemorrhage increases and intracerebral pressure decreases, the cerebrovascular resistance depresses during a short period of time. Then they reverse with the automatic regulation of cerebral blood flow.
出处
《卒中与神经疾病》
2002年第4期224-226,共3页
Stroke and Nervous Diseases
基金
武汉市科委资助项目 (No .2 0 0 1 177)
关键词
经颅多普勒
TCD
自发性脑出血
甘露醇
血流动力学
Transcranial Doppler(TCD) Spontaneous Intracerebral Hemorrhage Mannitol Hemodynamics
