Schröder M L, Muizelaar J P
Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Acta Neurochir Suppl (Wien). 1993;59:47-9. doi: 10.1007/978-3-7091-9302-0_8.
During the last few years continuous measurements of CBF by means of a thermal diffusion blood flow probe have been proposed as a possible means for monitoring the patient's CBF in a clinical setting. Also, it has been suggested that continuous CBF data from head injured patients can be correlated with other continuously recorded clinical parameters, such as ICP and blood pressure, in order to clarify pathophysiological mechanisms such as "plateau-waves". We measured regional cortical blood flow continuously with a thermal diffusion flow probe in 13 comatose head injured patients after undergoing craniotomy for evacuation of a traumatic intracranial mass lesion in order to assess the reliability and usefulness of the method. In seven patients stable Xenon-CT CBF studies were performed with the flow probe in place, in order to compare the two methods. The continuous blood flow values did not correlate with regional or global stable Xenon-CT values. These results indicate that continuous monitoring of CBF with the thermal diffusion method as currently used cannot be used in the clinical management of the patient. Further research will have to be directed to the question as to whether changes in CBF are reliably measured with this method. If this is true, the thermal diffusion flow probe with its high temporal resolution may still be useful in investigating pathophysiological mechanisms such as interaction between CBF, ICP, mean arterial blood pressure (MABP), and end-expiratory CO2 (etCO2).
在过去几年中，有人提出使用热扩散血流探头连续测量脑血流量（CBF），作为在临床环境中监测患者CBF的一种可能方法。此外，有人认为，头部受伤患者的连续CBF数据可以与其他连续记录的临床参数（如颅内压和血压）相关联，以阐明诸如“高原波”等病理生理机制。我们使用热扩散血流探头对13例昏迷的头部受伤患者进行了开颅手术以清除创伤性颅内肿块病变后，连续测量其局部皮质血流量，以评估该方法的可靠性和实用性。在7例患者中，在放置血流探头的情况下进行了稳定的氙CT CBF研究，以比较这两种方法。连续血流值与局部或整体稳定的氙CT值不相关。这些结果表明，目前使用的热扩散法连续监测CBF不能用于患者的临床管理。必须针对该方法是否能可靠测量CBF变化的问题进行进一步研究。如果情况确实如此，具有高时间分辨率的热扩散血流探头在研究诸如CBF、颅内压、平均动脉血压（MABP）和呼气末二氧化碳（etCO2）之间的相互作用等病理生理机制方面可能仍然有用。
