应用经颅彩色多普勒超声(TCCD)监测术中不同血压及呼气末二氧化碳分压(P_ETCO₂)下患者脑血流量的变化，以探讨TCCD在术中脑血流监测中的可行性。

选择2022年7月至2022年10月于南京医科大学附属常州第二人民医院行腹腔镜手术患者30例，其中男性16例，女性14例；年龄25～70岁，平均(57±19)岁。患者入室后均采用经颅多普勒(TCD)和TCCD分别测量大脑中动脉血流频谱信息，麻醉后均全程监测患者局部脑氧饱和度(rcSO2)，同时采用TCCD测量并计算麻醉诱导后血压正常时，P_ETCO₂分别≤35 mmHg(T1)、35 mmHg～45 mmHg(T2)、≥45 mmHg(T3)；血压下降>30%时P_ETCO₂分别≤35 mmHg(T4)、35 mmHg～45 mmHg(T5)和≥45 mmHg(T6)六个时刻大脑中动脉的血流量。

(1)血压下降>30%时，大脑中动脉血流量较血压正常时明显降低(F＝49.73，P<0.01)。(2)当血压维持一定时，随着P_ETCO₂逐渐增加，大脑中动脉血流量也逐渐增多(F＝50.33，P<0.01)，且血压与P_ETCO₂的影响具有交互作用(F＝3.21，P<0.05)。(3)TCCD与TCD及rcSO₂具有良好的相关性。

TCCD能够实时有效监测术中脑血流量变化，且与TCD，rcSO₂具有良好的相关性，具有较好的临床应用价值。

To explore the feasibility of transcranial color Doppler ultrasound (TCCD) to monitor the changes of cerebral blood flow in patients with different intraoperative blood pressure and carbon dioxide partial pressure.

Thirty patients with laparoscopic elective surgery were selected, including 16 males and 14 females, aged 25~70 years, with an average age of (57lective surgery were selectedtranscranial Doppler and TCCD were used to measure the middle cerebral artery blood flow spectrum of all the patients, and to monitor cerebral oxygen saturation (rcSO₂) throughout the process after anesthesia. At the same time, TCCD was used to measure and calculate cerebral blood flow after anesthesia induction at the time point of when the blood pressure was normal, P_ETCO₂ was ect mmHg (T1), 35 mmHg-45 mmHg (T2), and ti mmHg (T3), respectively; when the blood pressure decreased by more than 30%, P_ETCO₂ was ect mmHg (T4), 35 mmHg-45 mmHg (T5) and o45 mmHg (T6), respectively.

Compared with the normal blood pressure, the cerebral arterial blood flow decreased significantly when the blood pressure decreased by more than 30% (F=49.73, P<0.010). When the blood pressure was maintained, with the gradual increase of P_ETCO₂, the cerebral arterial blood flow also gradually increased (F=50.33, P<0.010), and blood pressure had an interaction with the influence of P_ETCO₂ (F=3.21, P<0.050). TCCD had a good correlation with TCD and rcSO₂.

TCCD can effectively monitor the changes of intraoperative cerebral blood flow in real time, and has a good correlation with TCD, rcSO₂, and therefore it has good clinical application value.