Meyerson B A, Gunasekera L, Linderoth B, Gazelius B
Department of Neurosurgery, Karolinska Hospital, Stockholm, Sweden.
Neurosurgery. 1991 Nov;29(5):750-5. doi: 10.1097/00006123-199111000-00018.
Continuous beside monitoring of regional cerebrocortical blood flow was carried out using laser Doppler flowmetry (LDF) in four comatose patients. Newly designed thin and flexible optical probes that were easily implanted into the cortex were employed. When the patients were in a deep comatose state, the recordings revealed a conspicuous relationship to intracranial pressure. As the patients improved, the flux values gradually increased, and the recordings showed characteristic changes in the wave pattern, presumably related to the restoration of an impaired cerebral autoregulation. Changes in regional cerebrocortical blood flow were also observed during routine nursing procedures, the use of medications, and voluntary activities, as demonstrated by one patient after a complete recovery. Although the volume of tissue scanned with LDF was limited, and the flux values did not directly express regional cerebrocortical blood flow in terms of milliliters per unit volume, changes in cerebral circulation were portrayed clearly in the flow recordings. Thus, LDF, which is simple to use, permits continuous bedside monitoring of the cerebral microcirculation. Its use should improve the management of comatose patients and also open avenues for a better understanding of the cerebral circulation in pathological states.
使用激光多普勒血流仪（LDF）对4例昏迷患者进行了局部大脑皮质血流的床边连续监测。采用了新设计的易于植入皮质的薄且灵活的光学探头。当患者处于深度昏迷状态时，记录显示与颅内压有明显关系。随着患者病情好转，通量值逐渐增加，记录显示波形有特征性变化，推测与受损的脑自动调节功能的恢复有关。如1例完全康复的患者所示，在常规护理操作、用药和自主活动期间也观察到了局部大脑皮质血流的变化。尽管LDF扫描的组织体积有限，且通量值不能直接以每单位体积毫升数来表示局部大脑皮质血流，但血流记录中清楚地描绘了脑循环的变化。因此，操作简单的LDF可在床边对脑微循环进行连续监测。其应用应能改善昏迷患者的管理，并为更好地理解病理状态下的脑循环开辟途径。
