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1.
目的:通过彩色多普勒超声检测锁骨下动脉窃血综合征,为临床提供锁骨下动脉狭窄及脑缺血情况,确定治疗方案及治疗后随查.方法:对12例临床表现为椎一基底动脉供血不足和患侧上肢缺血症状的患者进行无名动脉、锁骨下动脉、颈部动脉、椎动脉的彩色多普勒超声检查,观察无名动脉或锁骨下动脉有无狭窄或闭塞.结果:锁骨下动脉狭窄4例,锁骨下动脉闭塞1例,椎动脉返流7例.结论:彩色多普勒超声为临床诊断、治疗脑血管疾病,提供了科学有效的诊断方法.  相似文献   

2.
检测重度颈动脉狭窄患者支架成形术(CAS)前后的脑血管反应性(CVR),分析重度颈动脉狭窄患者颈动脉支架成形术术前与术后的脑血管反应性变化,以期为临床治疗与预后提供依据.方法:重度颈动脉狭窄患者(试验组)46例,健康对照者(对照组)10名,采用德国DWL MDX 0630型TCD检测仪,检测试验组患者术前、术后3天及术后3个月的CVR,对照组患者亦同期随访.结果:1.试验组与对照组比较:试验组的VMR、BHI、CRC值与对照组比较有明显差异(P0.05),对照组双侧VMR、BHI、CRC结果无统计学差异.2.VMR、BHI、CRC值术前与术后比较有明显差异(P0.05),术后3天及3个月无明显差异.3.呼气末CO2分压(PCO2):对照组与试验组呼气末CO2浓度变化无统计学差异.结论:1.重度狭窄患者CVR明显减低,CAS术改善了CVR.2.CVR对于CAS术前评估及术后疗效的随访是较好的临床观测指标.  相似文献   

3.
目的:探讨经颅多普勒与彩色多普勒超声联合检查头臂型大动脉炎的价值。方法:应用彩超和TCD检查7例头臂型大动脉炎患者的颅内和颅外动脉.分析二维及血流动力学指标。结果:头臂型大动脉炎病变多位于颅外动脉起始段或近心端(84%);颅外段动脉狭窄程度与颅内动脉流速呈大致负相关;结论:彩超与TCD联合检查头臂型大动脉炎,对于了解动脉炎所致血管狭窄的分布情况及分析颅外动脉狭窄或闭塞对颅内循环的影响具有重要诊断价值。  相似文献   

4.
目的:讨论颈动脉支架成形术治疗症状性颈动脉狭窄的短期疗效和安全性。方法:25例症状性颈动脉狭窄病人(狭窄率>70%)采用颈动脉支架治疗,随访1至12个月。结果:25例患者手术操作完全成功,术后残余狭窄小于20%。1~12个月后TCD及颈动脉彩超未显示再狭窄。结论:颈动脉支架成形术治疗症状性颈动脉狭窄是一种安全可行的方法,短期疗效肯定。  相似文献   

5.
颈动脉是一个流向大脑的血液通道,对大脑正常功能的维护有着重要的意义。当各种原因造成该通道内部管径变小,就称作颈动脉狭窄。颈动脉狭窄有什么影响?今天我们来一起认识一下颈动脉狭窄。最常见导致颈动脉狭窄的原因是颈动脉硬化,这占据90%以上。其他有先天性纤维肌性发育不良、动脉迂曲、外部压迫、创伤性闭塞、夹层、炎性血管病、放射性血管炎及淀粉样变性等。  相似文献   

6.
目的探讨超声检测对早发现、早诊断老年人颈动脉硬化的意义.方法采用HDI5000型彩色多普勒超声诊断仪探头L5-12MH2纵横切面法,对大同市第五人民医院住院和门诊高血压、冠心病、脑梗塞老年患者进行颈动脉结构和血流动力改变的检测.结果①该方法能准确明晰颈动脉不同部位的血流参数;②2/3患者有颈动脉1支或多支血管内膜-中层不同程度增厚,主要部位是颈总动脉分叉部和双侧颈总动脉;2/3以上患者有粥样硬化斑块形成,最易形成部位为颈总动脉分叉部,其次是颈内动脉.结论HDI5000型彩色多普勒超声诊断仪可为预示粥样硬化斑块形成提供确切依据,并能准确地给予定位和定性,评价其病变程度.故超声是早发现、早诊断老年人颈动脉硬化以及定位、定性的有效手段,将其应用于普查和筛查心脑血管疾病,具有不可估量的经济效益和社会意义.  相似文献   

7.
目的:讨论经颅多普勒超声(TCD)在脑动静脉畸形的临床应用价值既对病人的初筛.方法:用TCD对几年来就诊病人中发现的8例脑动静脉畸形病人进行总结.用4MHz连续波探头分别查颈部的颈总动脉、颈外动脉、颈内动脉、锁骨下动脉.用2MHz探头分别监测颅内大脑中动脉、大脑前动脉、颈内动脉末端、大脑后动脉同时进行压颈试验和二氧化碳反映试验及脑血流自定调节功能检测。结果:用TCD检查后发现了供血动脉高流速低搏动指数的频谱及对二氧化碳反应性和脑血流自动调节功能降低,发现了血流速增高和搏动降低与血管床有直接关系,血管床越大,血流速越快,发现了ArM对脑血流的自动调节功能扣二氧化碳反应性降低时动静脉畸形比较特异的指标.讨论:目前,脑动脉畸形患者日趋增多,用TCD检查快捷方便,对病人无损害经济实惠,对进一步脑血管造影进行初筛.  相似文献   

8.
目的探讨颈动脉硬化与高血压病的关系、方法应用彩色多普勒超声监测35例正常人,30例单纯型高血压患者和52例高血压合并心脑血管患者的颈动脉。结果高血压组与正常组比较颈动脉内膜粗糙增厚,粥样硬化斑块的发生率明显增高,高血压合并心脑血管病组内膜粗糙增厚更为明显,斑块的形成更为多见,并以混合型斑块为主。结论 颈动脉粥样硬化斑块的形成与高血压病及合并的心脑血管疾病的发生密切相关,超声检查是检测颈动脉粥样硬化的可靠方法  相似文献   

9.
目的:探讨结肠造瘘后造瘘口狭窄的病因及治疗方法.方法:对18例结肠造瘘口狭窄的病因和治疗方法进行回顾性分析.结果:18例结肠造瘘口狭窄除1例直肠破裂患者行狭窄部位切除,对端吻合,造瘘口关闭;1例因结肠癌多部位复发行结肠切除,回肠右下腹重新造瘘外,余16例患者均行狭窄切除,原位造瘘术,术后3个月均内排便通畅,无一例复发.结论:造瘘口狭窄的病因多见于造瘘口周围炎、造瘘口周围网膜或肠管疝、造瘘口周围出血或异物反应、原发造瘘口过小等因素.此外,造瘘管过短、造瘘肠管血运障碍、肿瘤复发等诸因素亦占一定比率.行造瘘口狭窄矫正后,可获满意疗效.  相似文献   

10.
目的探讨各级高血压病与颈动脉硬化之间的关系。方法对558例高血压病患者的颈动脉内膜中层厚度(IMT)、斑块发生率进行检查分析,并与209例健康成人对照。结果各级高血压患者颈动脉IMT与对照组相比均有明显增加;各级高血压病患者颈动脉IMT之间进行比较亦显示出显著性差异;颈动脉IMT随高血压分级增加而逐渐增厚。结论血压增高与高血压病患者颈动脉变化密切相关,颈动脉超声检测对于防治高血压及其并发症具有重要意义。  相似文献   

11.
目的:研究冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床意义。方法:采用高频超声测量冠心病组和对照组颈动脉斑块积分、斑块数、颈动脉内-中膜厚度(IMT)及血管内皮舒张功能(EDD%),并进行对比分析。结果:1.冠心病组颈动脉IMT、斑块积分及斑块数明显高于对照组,多支冠脉血管病变组明显高于单支病变组;2.冠心病组内皮舒张功能明显低于对照组,单支、双支病变组间无显著性差异。3.冠状动脉造影与颈动脉超声结果比较,以斑块存在为预测冠脉病变的阳性指标,敏感性为83%、特异性75%。结论:冠心病患者多合并血管舒张功能受损及颈动脉粥样硬化,高频超声探查颈动脉可预测冠状动脉病变的存在及严重程度。  相似文献   

12.
目的:探讨磁共振成像(MRI)和经颅多普勒(TCD)评价后循环缺血的价值。方法:对56例诊断为后循环缺血患者的临床资料进行回顾性分析。结果:头颅MRI发现脑干、小脑、枕叶梗死灶共46个;椎基底动脉磁共振血管造影显示达39例(69.6%)双侧椎动脉不对称、粗细不均,10例(17.9%)一侧椎动脉起始段不同程度狭窄,1例锁骨下动脉狭窄。TCD显示血流速度异常者40例(71.4%),频谱异常36例(64.3%)。结论:MRI和TCD能给后循环缺血的诊断提供客观依据;MRI优于TCD。  相似文献   

13.
目的 探讨老年性糖尿病患者的胰岛素抵抗与颈动脉粥样硬化之间的关系。方法 通过对 42例伴颈动脉粥样硬化的老年糖尿病患者 (CAA组 ) ,40例不伴颈动脉粥样硬化的老年糖尿病患者 (非CAA组 ) ,检测其血浆胰岛素及血糖、血脂等指标并相比较。结果 两组间InS、LDL、CHOL差异有显著性意义 (p <0 0 5 ) ,InS水平与患者LDL、CHOL间存在正相关。结论 HI(高胰岛素血症 )可能通过对糖尿病患者脂质代谢的影响 ,发挥其在动脉粥样硬化形成过程中的作用。  相似文献   

14.
目的:进一步探讨脊髓型颈椎病与发育性颈椎管狭窄的关系。方法:应用比值法对70例正常人和110例脊髓型颈椎病患者的X线侧位片进行统计学测量与比较,研究范围从C3~C7。结果:C3~C7正常组与颈椎病组的椎管中矢径比值有显著性差异。结论:发育性颈椎管狭窄是脊髓型颈椎病的重要发病因素。  相似文献   

15.
Renal artery stenosis (RAS) with a bifurcation lesion is a challenge for interventional therapy. The aim of this study is to summarize our experience in RAS with a bifurcation lesion. Five patients with RAS involving bifurcation lesion are described. In cases 1 to 3, a single-stent strategy was first adopted. However, these three patients were converted to a two-stent strategy for bailout stent implantation in the side branches. In cases 4 and 5, a simultaneous kissing stent technique was performed. Angiography showed that the reference vascular diameter of the main branch was much larger than those of the side branches. Although obvious residual stenosis existed in cases 1 to 3 after stent implantation, no obvious residual stenosis was seen in cases 4 and 5. Renal artery duplex sonography was performed in cases 1 through 5 at 6, 7, 7, 8, and 6 months, respectively, after the procedures. No evidence of restenosis or occlusion was seen. In conclusion, stent implantation with the simultaneous kissing stent technique may result in more simple and more satisfactory immediate angiographic results.  相似文献   

16.
Two case reports of emergent anesthesia of critical tracheal stenosis are presented. The use of extracorporeal circu-lation may be a lifesaving method for these patients. Two patients both with severe lower tracheal stenosis were admitted with severe inspiratory dyspnea. The first patient had a tracheal tube inserted above the stenosis in the operating room, but ventilation was unsatisfactory, high airway pressure and severe hypercarbia developed, therefore extracorporeal circulation was immediately initiated. For the second patient, we established femoral-femoral cardiopulmonary bypass prior to induction of anaesthesia, and intubated above the tracheal tumor orally under general anesthesia, then adjusted the endotracheal tube to appropriate depth after the tumor had been resected. The patient was gradually weaned from cardiopulmonary bypass. The two patients all recovered very well after surgery. Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. Extracorporeal circulation by the femoral artery and femoral vein cannulation can gain good gas exchange even if the trachea is totally obstructed. Therefore, before the induction of anesthesia, we should assess the site and degree of obstruction carefully and set up cardiopulmonary bypass to avoid exposing the patient to unexpected risks and the anesthesiologist to unexpected challenges.  相似文献   

17.
Two case reports of emergent anesthesia of critical tracheal stenosis are presented. The use of extracorporeal circulation may be a lifesaving method for these patients. Two patients both with severe lower tracheal stenosis were admitted with severe inspiratory dyspnea. The first patient had a tracheal tube inserted above the stenosis in the operating room, but ventilation was unsatisfactory, high airway pressure and severe hypercarbia developed, therefore extracorporeal circulation was immediately initiated. For the second patient, we established femoral-femoral cardiopulmonary bypass prior to induction of anaesthesia, and intubated above the tracheal tumor orally under general anesthesia, then adjusted the endotracheal tube to appropriate depth after the tumor had been resected. The patient was gradually weaned from cardiopulmonary bypass. The two patients all recovered very well after surgery.Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. Extracorporeal circulation by the femoral artery and femoral vein cannulation can gain good gas exchange even if the trachea is totally obstructed. Therefore, before the induction of anesthesia, we should assess the site and degree of obstruction carefully and set up cardiopulmonary bypass to avoid exposing the patient to unexpected risks and the anesthesiologist to unexpected challenges.  相似文献   

18.
目的:评估经导管主动脉瓣置入术在中国人群二叶式主动脉瓣重度狭窄中的安全性和有效性。创新点:首次在中国人群比较经导管主动脉瓣置入术在二叶式和三叶式主动脉瓣重度狭窄中的安全性和有效性。方法:选取2013年3月至2014年9月行经导管主动脉瓣置入术的40位主动脉瓣狭窄的患者,分二叶式和三叶式主动脉瓣两组,比较基线水平、手术以及随访1月结果的差别。结论:经导管主动脉瓣置入术在中国人群中二叶式主动脉瓣重度狭窄中的应用是安全有效的。  相似文献   

19.
目的:探讨藻酸双脂钠(PSS)治疗急性脑梗死患者血液成分变化及疗效。方法:急性脑梗死患者158例,随机分为两组。对照组:78例,常规治疗;治疗组:80例,在常规治疗基础上,应用藻酸双脂钠注射液100mg加入0.9%氯化钠静脉滴注,每日一次,连续观察14d。对比分析二组治疗前后脂蛋白(a)、血脂、纤维蛋白原等血液流变学指标.并动态观察治疗前后临床神经功能缺损评分。结果:藻酸双脂钠可降低全血粘度、血浆粘度、血小板聚集率、纤维蛋白原及血清TC、TG、LDL,与治疗前比较有显著性改变(P〈0.01或P〈0.05);与对照组比较有显著性差异(P〈0.01或P〈0.05).但对脂蛋白(a)无影响;近期预后较常规治疗组好(P〈0.05).结论:藻酸双脂钠可改善血液高粘滞状态,起到降低纤维蛋白原、抗血小板聚集作用,可改善近期临床神经功能缺损程度。  相似文献   

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