摘要
目的观察不同手术时间段颅骨缺损修补术对脑血流动力学变化的影响。方法回顾性分析30例行单侧颅骨缺损修补术患者，根据手术时间分为早期组（〈3月）和晚期组（≥3月）。于颅骨修补术前3-4天和术后10-14天，应用256排螺旋CT行脑灌注扫描，记录患侧大脑皮质、基底核和丘脑区域灌注图像上rCBY、rCBF、MTT及TTP等参数值。分析不同颅骨修补时间段的脑血流灌注数据改变量的变化情况。结果早期颅骨修补组手术前后患侧皮质、基底核区rCBF的改变量[14．94±3．42ml／（100g·min）、14．41±3．98ml／（100g·min）]明显大于晚期组手术前后皮质、基底核区的改变量[10．74±4．04ml／（100g·min）、9．94±5．12ml／（100g·min）]，差异有统计学意义（P〈0．05），同时早期修补组基底核区的MTT的改变量（-2．10±1．59s）和晚期组（-0．96±1．09s）相比差异有统计学意义（P〈0．05）。结论早期颅骨修补更有利于改善脑灌注。
Objective To observe the influence of different operation time about cranioplasty on cerebral hemodynamics. Methods Thirty patients who were undergoing early（ 〈 3 months） or late（ ≥ 3months） cranioplasty after decompressive craniectomy were analysed retrospectively. We collected data about regional rebral blood volume （rCBV） , regional cerebral blood flow （rCBF） , mean transit time （MTT） and transit time peak （TTP） at the affected cortex, basal nuclei and thalamus which were recorded by 256 CT perfnsion tech- nique,then calculated the changes of these data between 3 -4 days before and 10 - 14 days after surgery and analyzed by the software SPSS 11.5. Results The changes of CBF at injured side cortex [ 14.94 ± 3.42ml/（ 100g · min） ], basal nuclei [ 14.94±3.42ml/ （100g · min）] in the early group compared with late craniplasty [ cortexl0.74 ± 4.04ml/（ 100g · min）, basal nuclei 9.94 ± 5.12ml/ （ 100g · min） ] were increased statistically （P 〈 0.05 ）. The changes of MTT in the early group （ - 2. 10 ± 1.59s） and late craniplasty - 0.96 ± 1.09s） were also statistically slgnifieanct （P 〈 O. 05）. Conclusion Early craniplasty has potential benefits for cerebral perfusion
出处
《医学研究杂志》
2015年第5期104-107,共4页
Journal of Medical Research
作者简介
李永财，主任医师，电子信箱：yelee7833@hotmail．com
