| Objective:The major reason of the posterior circulation ischemia is atherosclerosis. The mechanism for the posterior circulation ischemia is the large artery stenosis and occlusion which caused the artery low perfusion, thrombosis and embolism. We found that those patients with vertebral artery blood flow acceleration time prolonged, namely from systole begins to form maximum peak flow velocity and the time prolonged, when we use the color Doppler Ultrasound to observe the patients' vertebral artery, and those patients with posterior circulation ischemia. The effect of ultrasound treatment combined with conventional drugs treatment for patients with posterior circulation ischemia has great significantly improved than the only application of conventional drugs treatment. The ultrasonic treatment can change the permeability of the cell membrane, increase metabolism, dilate blood vessels, promote blood circulation and lymph circulation, improve cell hypoxia and hypoxia, improve tissue nutrition and blood circulation. From the treatment effect, the patient's clinical symptoms were relieved and disappeared. After treatment, the vertebral artery blood flow acceleration time is reduced accordingly under the color Doppler Ultrasonography. So we thought that the ultrasonic therapy has a good high correlation with vertebral artery blood flow acceleration time. The aim of this study was to analyze the relationship between ultrasound treatment and vertebral artery blood flow acceleration with the color Doppler ultrasound. To improve the prognosis of patients with posterior circulation ischemia by the combination of basic drugs and ultrasonic treatment. Comparative analysis of basic drugs combined with ultrasonic therapy improves blood flow in patients with posterior circulation ischemia and prognosis.Methods:A prospective randomised control trial was carried out from December 2014 to May 2015 in The Eighth hospital of Shijiazhuang. A total of 100 patients with posterior circulation ischemia meeting the enrolment criteria, 56 males, 44 females; age ranged from 46 to 75 years old, average 62.47±6.82 years old. All patients and their families were informed and agreed to this experiment. The experiment was approved by the ethics committee of the Eighth Hospital of Shijiazhuang and supervision and management. All the patients were randomly divided into 2 groups(the experimental group and control group) administrated different therapy. Fifty patients were treated with basic treatment as the control group and 50 patients were treated with basic drugs and ultrasonic treatment as the experimental group. The basic medicine treatment of two groups of patients with no difference.Ultrasonic treatment: the experimental group underwent ultrasonic therapy in the vertebral artery in the body surface projection area. 2 times/ day, 20 minutes each time, 14 consecutive days. Basic drug therapy: Aspirin, Simvastatin, Muscular amino acids and nucleosides, Shuxuetong, and low molecular weight Heparin. The color Doppler ultrasound examination was used to record the end of the vertebral artery systolic blood flow velocity, end diastolic blood flow velocity and vertebral artery blood flow acceleration time and record. The color Doppler ultrasound imaging instrument was used to did the vertebral artery ultrasound examination. Probe frequency 10 MHz, the patients take supine position, after the neck a bit high, so that the head slightly upward. Measurement of vertebral artery of cervical vertebrae and 2 cervical vertebra transverse process of the 4 gap segment diameter, the end systolic period, the end diastolic period and mean peak blood flow velocity, blood flow acceleration time. After 14 days of different treatment, the two groups received the same basic medicine and rehabilitation therapy.Clinical outcomes were compared between the two groups by using the Glasgow prognosis score and the degree of vertigo. Application of color Doppler ultrasound for the detection of the two groups of patients with vertebral artery blood flow acceleration and the correlation between the treatment.Observation index:(1) the peak value of the vertebral artery is: the time of the vertebral artery blood flow acceleration is less than 120 ms. The peak time of the vertebral artery blood flow acceleration is greater than 120 ms. Treatment was effective: the peak time was shortened or returned to normal(2) the end systolic period, the end diastolic period and mean peak blood flow velocity, before and after treatment.(3) the length of stay in Hospital;(4) the vertigo score, ADL score;(5) Glasgow Outcomes Score.Results:A total of 100 patients with posterior circulation ischemia meeting the enrolment criteria, 56 males, 44 females; age ranged from 46 to 75 years old, average 62.47±6.82 years old. The clinical symptom of two groups patients include: vertigo, nausea/vomiting, eyes movement abnormalities, weakness of extremities, falling seizures and the Masonic disorders. There were no significant differences in average age, sex, duration of disease and clinical manifestations between the two groups(P > 0.05).Before treatment, the basic drug combined with ultrasonic therapy apparatus in treatment group and simple basic drug treatment group patients with bilateral vertebral artery systolic blood flow velocity, end diastolic velocity of blood flow of peace were peak flow compared were no difference was not statistically significant(P > 0.05); blood flow acceleration difference also no statistical significance(P > 0.05).After the experimental treatment, the blood flow velocity and end diastolic blood flow velocity in the experimental group were significantly higher than those before treatment.(t=3.41 ~ 6.96, P < 0.01). The mean blood flow velocity was significantly faster than that before treatment in the experimental group(t=2.57, P < 0.05). In the experimental group, the blood flow acceleration time was significantly decreased after treatment(t=18.16, P < 0.01).After treatment, the end diastolic blood flow velocity and end diastolic blood flow velocity in the experimental group were significantly increased compared with the control group(t=2.79 ~ 5.42, P < 0.01). The mean peak flow rate in the experimental group was higher than that in the control group(t=2.94, P < 0.01). Experimental group bilateral vertebral artery blood flow acceleration time was significantly less than the control group patients(t=17.72, P < 0.01).The ADL score of the experimental group was better than that before treatment(t=9.48, P < 0.01); the ADL score of the experimental group was significantly higher than that of the control group after treatment(t=7.10, P < 0.01). GCS prognostic score, the control group was lower than the experimental group(t=2.31, P < 0.05); the experimental group was shorter hospitalization time than the control group(t=2.44, P < 0.05).Conclusions:In this study, we compared the vertebral artery blood flow in patients with the basic blood circulation drugs combined with ultrasound treatment and in patients with only the basic blood circulation drugs. The combination of basic medicine and ultrasonic treatment can significantly improve the vertebral artery blood flow velocity in the end of the vertebral artery, and the end diastolic and the end diastolic. Compared with the basic medicine simple drug therapy, the blood flow acceleration time of vertebral artery was significantly shorter in the patients treated with the combination of basic drugs and ultrasound therapy. The combination of basic drugs and ultrasonic treatment can significantly increase the blood flow velocity of vertebral artery, and improve the clinical outcome of patients with posterior circulation ischemia. |
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