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Application of TCD Technique in Clinical Anesthesia Research
蒋新奇1,刘慧丽2 综述 孙 莉1,黄宇光2 审校
1中国医学科学院肿瘤医院麻醉科,北京 100021
2中国医学科学院协和医院麻醉科,北京 100730
Xin-qi Jiang,Li Sun,Hui-li Liu,Yu-guang Huang
1Department of Anesthesiology,Tumor Hospital under the Chinese Academy of Medical Sciences
2Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China
Abstract
The changes of cerebral blood flow during anesthesia are very complicated,while TCD technique can provide a noninvasive,real time,simple monitoring during anesthesia. In recent years,TCD technique has been widely used in the field of clinical anesthesia research. The related literatures are briefly reviewed in this article.
Key words:TCD;cerebral blood flow mornitoring;anesthesia
正常成人平均脑血流量为50±5ml/(100g/min-1),不同部位脑组织的血流量分布并不均匀,局部脑血流量、脑代谢率与脑的功能活动密切相关。平均动脉压在60-160mmHg范围内时,脑血流量具有正常的自动调节功能,一些化学因素(如二氧化碳)和血液动力学参数(如血液粘度)等也可影响脑血流量。麻醉过程中,各种麻醉药物、体位、手术操作等均可导致脑血流量的变化,所以围术期监测脑血流量具有重要意义。
脑血流的监测方法多样,但各有利弊,包括颈内动脉注射示踪剂Xe测定法、阻抗血流图测定法、近红外光光谱测定法、正电子发射断层测定法(PET)、颈内静脉球血氧饱和度以及经颅多普勒超声测定法等。而TCD可对脑血流进行无创的实时性监测,操作简单、可重复性强,在临床工作和科研实验中具有广阔的应用空间。本文对国内外相关研究进行综述如下。 |