文章摘要
陶杰,邓旦,匡永勤,吴晓波,常明,陈重,冯谦.颅脑火器伤后犬颈内动脉血流动力学改变的初步观察[J].声学技术,2013,32(1):37~40
颅脑火器伤后犬颈内动脉血流动力学改变的初步观察
Observation of the hemodynamic change of the internal carotid artery with craniocerebral fire-arm injury of dogs
投稿时间:2011-08-17  修订日期:2011-10-27
DOI:10.3969/j.issn1000-3630.2013.01.009
中文关键词: 超声检查  颈内动脉  颅脑  枪弹伤  颅内压
英文关键词: ultrasonography  internal carotid artery  brain  gunshot wounds  intracranial pressure
基金项目:全军医药卫生科研基金项目资助(06MA146)
作者单位E-mail
陶杰 成都军区总医院超声科,成都 610083  
邓旦 成都军区总医院超声科,成都 610083 dengdan_888@126.com 
匡永勤 成都军区总医院脑外科,成都 610083  
吴晓波 成都军区总医院超声科,成都 610083  
常明 成都军区总医院超声科,成都 610083  
陈重 成都军区总医院超声科,成都 610083  
冯谦 成都军区总医院超声科,成都 610083  
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中文摘要:
      初步探讨颅脑火器伤后颈内动脉血流动力学变化及其临床意义。17只杂种犬,滑膛枪近距离由左额部射入钢珠建立犬颅脑枪弹伤模型。于伤前、伤后30min、2h、4h、6h检测右侧颈内动脉血流动力学参数:峰值流速(Vp)、舒张期末血流速度(Vd)、平均血流速度(Vm)、阻力指数(RI)和搏动指数(PI)。其间动态观测颅内压及动脉压。所有实验犬伤后30min颅内压较伤前已明显升高(P<0.01),动脉压降低(P<0.05),颈内动脉VpVmVd明显降低(P<0.05)。其中4只颅内压升高最为显著的犬RIPI明显增高,甚至在舒张早期出现负向频谱;另13只犬RIPI较伤前改变不明显。伤后其余各时间点如内生命体征维持较平稳,血流动力学参数均稳定在伤后第一次检查水平。颅脑火器伤后颈内动脉VpVmVd明显降低,但伤犬的血流动力学参数由于同时受颅内压升高、动脉压降低双重影响,难以准确判定其颅内压升高程度;部分伤犬RIPI明显增大,提示颅内压升高到一定程度、动脉压又显著降低,导致脑灌注压低于某一域值,此现象的出现可能存在潜在临床意义。
英文摘要:
      The hemodynamic change of the internal carotid artery after craniocerebral fire-arm injury and its clinical significance are discussed. A steel ball was shot in the left frontal part with a musket at close range and a model of craniocerebral gunshot wounds is established in 17 hybrid dogs. The hemodynamic parameters of the right internal carotid artery was detected 30 min, 2h, 4h, and 6h before and after causing trauma, including Vp, Vd, Vm, RI and PI. Intracranial pressure and arterial pressure were dynamically observed in the interim. Intracranial pressure was evidently elevated compared to the pre-traumatic period (P<0.01), arterial pressure dropped (P<0.05) and internal carotid Vp, Vm and Vd lowered markedly (P<0.05) 30 min after trauma. RI and PI increased markedly and negative frequency spectrum appeared even in the early diastolic phase in 4 of the dogs whose intracranial pressure was elevated most markedly. RI and PI did not change markedly compared to the pre-trauma period in other 13 dogs. The internal vital signs kept more stable at all other time points and the hemodgnamic parameter stabilized at the first examination level after trauma. Internal carotid Vp, Vm and Vd after craniocerebral fire-arm injury lowered markedly. Owing to the influence of elevated intra cranial pressure and lowered arterial pressure, the degree of the elevation of intracranial pressure is unable to decide accurately with the hemodynamic parameter in the injured dogs. RI and PI increase evidently in part of the injured dogs, suggesting that intracranial pressure is elevated to some extent while arterial perssure lowers markedly again,thus causing brain fusion pressure to lower than some threshold values. The occurrence of this phenomenon may be of potential clinical significance.
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