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目的探讨经颅多普勒(TCD)监测脑外伤患者脑血管痉挛(CVS)对护理观察的临床意义。方法对95例颅脑外伤患者进行动态TCD检查,并结合患者GCS评分、蛛网膜下腔出血量(t-SAH)量的多少对其结果进行统计评价。结果TCD检查结果与GCS评分、t-SAH量的多少相关,并与脑血管痉挛(CVS)的发展相一致,常在伤后1~3 d开始出现,3~7 d达高峰,2周后渐减轻。大脑中动脉平均血流速度(VMCA)>180 cm/s或VMCA<45 cm/s者预后差。患者症状、体征改变与CVS变化相一致。结论TCD检查是外伤后CVS动态监测的安全有效的方法,可以指导临床护理观察。
Objective To investigate the clinical significance of transcranial Doppler (TCD) in monitoring cerebral vasospasm (CVS) in patients with traumatic brain injury. Methods Ninety-five patients with traumatic brain injury underwent dynamic TCD examination, and the results were statistically evaluated according to the patients’ GCS score and the amount of subarachnoid hemorrhage (t-SAH). Results The TCD examination was correlated with the GCS score and the amount of t-SAH. It was consistent with the development of cerebral vasospasm (CVS). It usually started 1 to 3 days after injury and peaked at 3 to 7 days. After 2 weeks Gradually lighter. Poor middle cerebral artery blood flow velocity (VMCA)> 180 cm / s or VMCA <45 cm / s. Patient symptoms, signs and CVS changes consistent changes. Conclusion TCD is a safe and effective method for dynamic monitoring of CVS after trauma, which can guide clinical nursing observation.