Application of TCD in Monitoring Cerebral Blood Flow after Mechanical Thrombectomy for Acute Cerebral Infarction
Objective:To explore the application value of transcranial Doppler ultrasound (TCD)in monitoring cerebral blood flow after mechanical thrombectomy in acute cerebral infarction (ACI).Methods:85 ACI patients admitted to our hospital from June 2021 to August 2023 were selected as the study subjects,all of whom underwent mechanical thrombectomy treatment.After 7 days of treatment,the neurological function of the patients was evaluated using the Neurological Deficiency Scale (NIHSS),based on the difference before and after treatment(ΔNIHSS)will be grouped and ΔA score of NIHSS≥4 is classified as a good group for improving neurological function ΔNIHSS<4 points were classified as the group with poor neurological function improvement;Follow up until 90 days after treatment was conducted,and the patient's prognosis was evaluated using the Modified Rankin Scale (MRS).A score of MRS≤2 was classified as a good prognosis group,while a score of MRS >2 was classified as a poor prognosis group;TCD examination was conducted before and 7 days after treatment to clarify the changes in end diastolic blood flow velocity (EDV),peak systolic blood flow velocity (PSV),mean maximum blood flow velocity (MV),and pulsatile index (PI)of the middle cerebral artery.The differences in cerebral blood flow parameters before and after treatment and between different groups were compared.Results:After treatment,the EDV,PSV,and MV of the middle cerebral artery in 85 ACI patients were higher than before treatment,while the PI was lower than before treatment,with a statistically significant difference(P<0.05).The NIHSS score of 85 ACI patients before treatment was (12.25±1.52)points,and the NIHSS score after treatment was (7.52±1.12)points,ΔThe NIHSS score was (4.73 ±0.45),with 62 cases in the group with good neurological function improvement and 23 cases in the group with poor neurological function improvement;The EDV,PSV,and MV of the middle cerebral artery in the group with improved neurological function before and after treatment were higher than those in the group with poor neurological function improvement,and the PI was lower than that in the group with poor neurological function improvement,with a statistically significant difference(P<0.05).The MRS score of 85 ACI patients after 90 days of treatment was (1.89±0.23),of which 59 had a good prognosis and 26 had a poor prognosis;The EDV, PSV,and MV of the middle cerebral artery in the group with good prognosis before and after treatment were higher than those in the group with poor prognosis,and the PI was lower than those in the group with poor prognosis,with a statistically significant difference (P<0.05).Conclusion:TCD can evaluate the cerebral hemodynamic information of ACI patients after mechanical thrombectomy in cerebral blood flow monitoring,and the blood flow parameters are closely related to the patient's neurological function and recovery.It may be an important choice for early evaluation of postoperative cerebral blood flow in patients,providing a certain reference basis for clinical treatment.
万方数据
维普
