Volume 3,Issue 7
经颅多普勒超声在围术期脑保护中的应用
围术期脑部并发症是影响患者术后恢复及长期预后的重要因素，亟需有效的监测手段以优化脑保护策略。近年来，经颅多普勒超声(TCD)逐渐成为围术期脑血流监测的重要工具，其优势是无创性、实时性和高性价比。TCD可通过评估脑血流速度、自动调节功能及微栓子信号，为麻醉管理和手术操作提供动态数据支持，从而降低术后谵妄、认知功能障碍等风险。本文系统综述TCD在围术期脑保护中的最新应用进展，并探讨其临床价值与局限性。
[1]Razumovsky,AY,Jahangiri,FR,Balzer,J,et al. ASNM and ASN joint guidelines for transcranial Doppler ultrasonic monitoring: An update. J NEUROIMAGI
NG.2022;32(5):781-797.
[2]Svedung Wettervik, T, Beqiri, E, Hånell, A, et al. Visualization of Cerebral Pressure Autoregulatory Insults in Traumatic Brain Injury. CRIT CARE MED. 2024; 52 (8):
1228-1238.
[3]ONO M, BRADY K, EASLEY R B, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated
with major morbidity and operative mortality[J/OL]. The Journal of Thoracic and Cardiovascular Surgery, 2014, 147(1): 483-489.
[4]Sharma, P, Muthuchellappan, R, Bharadwaj, S, et al. Carbon dioxide induced cerebral vasomotor reactivity in moderate-to-severe cerebral venous thrombosis patients
and its impact on prognosis: A transcranial doppler-based prospective exploratory study. J CLIN NEUROSCI. 2024; 128 110779.
[5]de Moraes, FM, Adissy, ENB, Rocha, E, et al. Multimodal monitoring intracranial pressure by invasive and noninvasive means. Sci Rep. 2023; 13 (1): 18404.
[6]武春桃,邢英琦,白晶.经颅多普勒超声在颈动脉内膜切除术围术期的应用[J].中国卒中杂志,2014,9(03):198-203.
[7]Costa, M, Schmitt, P, N, J, et al. Transcranial Doppler emboli monitoring for stroke prevention after flow diverting stents. J Cerebrovasc Endovasc Neurosurg. 2023; 26 (1):
23-29.
[8]Kilgore, CB, Ran, KR, Kalluri, AL, et al. Perioperative Infection After Aneurysmal Subarachnoid Hemorrhage: Risk Factors, Causative Pathogens, and Long-Term Out
comes. NEUROSURGERY. 2023; 94 (2): 325-333.
[9]Ding, P, Chen, F, Qi, J, et al. Perioperative Brain Injury in Children with Aortic Arch Anomalies: A Retrospective Study of Risk Factors and Outcomes. PEDIATR CAR
DIOL. 2023; 45 (8): 1659-1667. .
[10]SCHRAAG S. Combined Monitoring—Brain Function Monitoring and Cerebral Oximetry[J/OL]. Journal of Cardiothoracic and Vascular Anesthesia, 2019, 33: S53-S57.