万文武;吴海波;滕志朋;彭形;王广;

• 1:重庆市中医院

摘要(Abstract)：

目的探讨颅骨修补术后颅内压及脑血流的变化情况,分析其临床应用价值。方法对20例颅骨缺损修补手术患者术前1 d和术后1周行腰椎穿刺术测定颅内压力,并对所有患者术前和术后1周进行CT灌注成像扫描(CTP),测量大脑皮质区、基底节区、大脑白质区脑血流容量(CBV)、脑血流流量(CBF)、造影剂平均通过时间(MMT)和对比剂达到峰值的时间(TTP)等参数,分析相关区域血流灌注情况。结果颅骨修补术前颅内压均偏低,术后颅内压力均较术前1 d明显改善(P<0.05)。颅骨修补术后大脑皮质区脑血流流量、脑血流容量较术前明显增加(P<0.05),术后造影剂平均通过时间、对比剂达到峰值时间较术前明显降低(P<0.05)。大脑皮质区术前患侧脑血流容量、脑血流流量均低于健侧(P<0.05),而造影剂平均通过时间、对比剂达到峰值的时间均高于健侧(P<0.05)。颅骨修补术后基底节区、大脑白质区脑血流流量、脑血流容量较术前有增加趋势,术后造影剂平均通过时间、对比剂达到峰值的时间较术前有下降趋势,但未见显著差异(P>0.05)。结论颅骨修补术可有效改善颅内压,维持颅内压在正常范围。CT灌注成像扫描能有效反映颅骨修补手术前后脑血流变化情况,颅骨修补术可显著改善大脑皮质区脑血流量。

关键词(KeyWords)： 颅骨修补;颅内压力;脑血流灌注;CT灌注成像;颅骨缺损

Abstract:

Keywords:

基金项目(Foundation): 2018年度重庆市科卫联合医学科研面上项目（编号：2018MSXM053）;; 2018年度成都中医药大学医院专项（编号：YYZX20180046）

作者(Authors): 万文武;吴海波;滕志朋;彭形;王广;

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