醫(yī)學(xué)免費(fèi)論文:SPECT在顱內(nèi)外血管吻合術(shù)療效評(píng)價(jià)中的作用探討

腦梗死患者治療后短期內(nèi)病變區(qū)域形態(tài)改變緩慢,其臨床征狀、體征有改善時(shí), CT掃描影像學(xué)上不一定有變化,而SPECT顯像可觀察到不同程度的變化[1-2]。應(yīng)用SPECT對(duì)術(shù)前，術(shù)后的循環(huán)代謝變化觀察有助于評(píng)價(jià)手術(shù)的療效。近年來(lái),有學(xué)者用SPECT顯像觀察藥物、針刺、體外反搏等對(duì)rCBF影響[3-9]。據(jù)報(bào)道,吻合術(shù)后患者臨床癥狀得以改善[10-12]。研究表明SPECT腦顯影與常用評(píng)價(jià)療效的Barthel指數(shù)呈正相關(guān)。本組患者治療前SPECT腦灌注顯像均有不同程度的放射性缺損,治療后伴隨臨床癥狀的改善,多數(shù)缺損區(qū)消失或縮小;圖像改變與臨床所見(jiàn)基本平行，均支持上述觀點(diǎn)。本研究結(jié)果間接支持部分學(xué)者的觀點(diǎn)，認(rèn)為頸內(nèi)動(dòng)脈閉塞或高度狹窄所致的腦缺血實(shí)施顱內(nèi)外動(dòng)脈吻合術(shù)可改善臨床癥狀，改善局部腦血流量，預(yù)防完全性卒中的發(fā)生。本組病例數(shù)較少,隨訪時(shí)間較短,但作者認(rèn)為缺血性腦血管病治療前后SPECT腦灌注顯像可直觀顯示血流及代謝的改變,從而反映治療效果，可以客觀、靈敏地為臨床療效評(píng)價(jià)提供客觀的參考依據(jù)醫(yī).學(xué)全.在.線網(wǎng)站gydjdsj.org.cn。

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