本文關(guān)鍵詞：經(jīng)顱多普勒超聲早期預(yù)測(cè)動(dòng)脈瘤夾閉術(shù)后遲發(fā)性腦缺血的臨床分析　出處：《山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年11期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 經(jīng)顱多普勒 遲發(fā)性腦缺血 動(dòng)脈瘤 蛛網(wǎng)膜下腔出血 顯微外科手術(shù)

【摘要】：目的評(píng)價(jià)經(jīng)顱多普勒超聲(TCD)對(duì)破裂動(dòng)脈瘤夾閉術(shù)后遲發(fā)性腦缺血(DCI)預(yù)測(cè)的敏感性,并初步探討影響DCI的危險(xiǎn)因素。方法回顧性分析67例破裂動(dòng)脈瘤行開(kāi)顱夾閉手術(shù)的患者臨床資料,分別用ROC曲線和Logistic回歸分析TCD對(duì)DCI的預(yù)測(cè)情況及影響DCI的危險(xiǎn)因素。結(jié)果出現(xiàn)DCI 18例,發(fā)生率為26.9%;大腦中動(dòng)脈平均血流速度(MCAVm)為149.5 cm/s時(shí)對(duì)DCI的預(yù)測(cè)準(zhǔn)確性最高,其靈敏度和特異度分別為88.9%和81.6%;改良Fisher分級(jí)和MCAVm≥130 cm/s與DCI的發(fā)生有顯著相關(guān)性。結(jié)論 TCD早期動(dòng)態(tài)監(jiān)測(cè)可有效預(yù)測(cè)動(dòng)脈瘤夾閉術(shù)后DCI,是指導(dǎo)治療和減少缺血性神經(jīng)功能損害的有效手段,并對(duì)改善患者預(yù)后有重要臨床意義,且改良Fisher分級(jí)和MCAVm≥130 cm/s是DCI發(fā)生的危險(xiǎn)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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