Abstract: 【Abstract】〓Objective〓To study the value of transcranial Doppler(TCD)in the prognosis of the patients with severe traumatic brain injury. Methods〓The prospective study included 62 severe traumatic brain injury patients from our hospital during Feb. 2013 to Oct. 2014, whom act as case group, and the data of the middle cerebral artery(MCA)blood flow was detected by TCD in the 1,3 7,14 and 21 days after the patients suffering from brain injury or operation. The peak systolic velocity (Vs), end diastolic velocity (Vd) and pulsatility index were observed. A total of 44 health people who accepted TCD scan in the same period were as control group. The data of case group were compared with that of control group. Results〓The velocity of brain blood flow was changing in the 1st day after injury or operation. Vs and Vd were declining to the lowest in the 7th day, and would gradually recover from then. But the trend of PI was contrary to above data. Vs was a protective factor for the severe traumatic brain injury in the 7th day. Conclusion〓The brain blood flow velocity detected by TCD can reflect the change and prognosis of intracranial pressure in the patients with sever traumatic brain injury,and has an important guiding value of the treatment for those patients.

Key words: Transcranial Doppler, TCD, Sever traumatic brain injury, Prognosis

摘要： 【摘要】〓目的〓探讨经颅多普勒超声检查(TCD)对重型颅脑损伤患者预后的判断价值。方法〓以2013 年2月至2014年10月在我院进行治疗的62例重型颅脑损伤患者作为病例组,并收集患者受伤后(术后)第1、3、7、14、21 d大脑中动脉的血流数据,以大脑中动脉收缩期血流速度(Vs)、舒张期血流速度(Vd)、博动指数(PI)作为观察指标;将同时期在我院接受TCD检查的健康44名对象作为对照组;将两组数据进行对比。结果〓患者受伤后(术后)第1 d脑血流速度即可发生改变;Vs和Vd值在第7 d降至最低,随后逐级恢复;PI指标则与脑血流速度变化趋势相反;第7 d的Vs是颅脑损伤的一个保护性因素。结论〓通过TCD检测的脑血流速度能反映重型颅脑损伤患者的颅内压力变化及预后情况,对颅脑损伤的治疗具有指导价值。

关键词: 经颅多普勒超声检查, TCD, 重型颅脑损伤, 预后