Gehring H, Meyer zu Westrup L, Berndt S, Joubert-Hübner E, Eleftheriadis S, Schmucker P
Klinik für Anästhesiologie, Medizinischen Universität Lübeck.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1997 Jun;32(6):355-9. doi: 10.1055/s-2007-995068.
The clinical relevance of transcranial Doppler sonography for the evaluation of cerebral perfusion and cerebrovascular regulatory mechanisms, as well as for the registration of embolic events, has increased considerably as a technique of non-invasive monitoring. The continuous measurement of blood flow velocities in two different vessel segments, either ipsilateral or contralateral, is limited by intricate probe fixation and positioning for optimal insonation of the vessel on the one hand. On the other hand probes are displaced frequently during anaesthesiological measures, so that continuous registration during induction of anaesthesia is not always guaranteed. In view of these limitations, a new probe-positioning and holding device has been developed and tested in a clinical study of patients undergoing cardiac surgery (n = 22). The newly designed probe-positioning and holding device allowed the unilateral adjustment and continuous measurement of the blood flow velocity in the middle cerebral artery (Vmca) from anaesthesia induction to endotracheal intubation in all patients (n = 9). This was possible in only 61.5% (n = 8) of the patients who were monitored via conventional mode of probe fixation (n = 13). The new method rendered possible the positioning, insonation and measurement in two vessel segments in 77.8% of the patients, in contrast to 53.8% of the patients where the conventional technique was used. The newly designed probe holding device meets all standard requirements from the anaesthesiological viewpoint, and facilitates the perioperative application of transcranial Doppler sonography for non-invasive monitoring.
经颅多普勒超声检查在评估脑灌注、脑血管调节机制以及记录栓塞事件方面的临床相关性，作为一种非侵入性监测技术已显著提高。一方面，连续测量同侧或对侧两个不同血管节段的血流速度，受复杂的探头固定和定位限制，难以实现对血管的最佳超声探测。另一方面，在麻醉操作过程中探头经常移位，因此麻醉诱导期间的连续记录并不总是能够保证。鉴于这些局限性，已开发出一种新的探头定位和固定装置，并在一项针对心脏手术患者（n = 22）的临床研究中进行了测试。新设计的探头定位和固定装置使所有患者（n = 9）从麻醉诱导到气管插管期间均能单侧调节并连续测量大脑中动脉的血流速度（Vmca）。而采用传统探头固定方式监测的患者（n = 13）中，只有61.5%（n = 8）能够做到这一点。与使用传统技术的53.8%的患者相比，新方法使77.8%的患者能够在两个血管节段进行定位、超声探测和测量。从麻醉学角度来看，新设计的探头固定装置符合所有标准要求，并便于经颅多普勒超声检查在围手术期用于非侵入性监测。
