[1]马菲韩,杜晓亮,王 胜,等.颈动脉内膜剥脱术后脑过度灌注综合征围手术期干预分析[J].医学信息,2018,31(18):91-94.[doi:10.3969/j.issn.1006-1959.2018.18.028]
　MA Fei-han,DU Xiao-liang,WANG Sheng,et al.Perioperative Intervention Analysis of Cerebral Hyperperfusion Syndrome after Carotid Endarterectomy[J].Journal of Medical Information,2018,31(18):91-94.[doi:10.3969/j.issn.1006-1959.2018.18.028]
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颈动脉内膜剥脱术后脑过度灌注综合征围手术期干预分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年18期
页码:
91-94
栏目:
临床研究
出版日期:
2018-09-15

文章信息/Info

Title:
Perioperative Intervention Analysis of Cerebral Hyperperfusion Syndrome after Carotid Endarterectomy
文章编号:
1006-1959（2018）18-0091-04
作者:
马菲韩; 杜晓亮; 王 胜; 厉春林
华中科技大学同济医学院附属同济医院神经外科，湖北 武汉 430030
Author(s):
MA Fei-han; DU Xiao-liang; WANG Sheng; LI Chun-lin
Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030, Hubei,China
关键词:
颈动脉内膜剥脱术; 颈动脉狭窄; 脑过度灌注综合征
Keywords:
Key words：Carotid endarterectomy; Carotid stenosis; Cerebral hyperperfusion syndrome
分类号:
R619+.9
DOI:
10.3969/j.issn.1006-1959.2018.18.028
文献标志码:
A
摘要:
目的 探讨颈动脉内膜剥脱术后脑过度灌注综合征围手术期干预。方法 回顾性分析2017年1月~11月我院57例患者因颈动脉狭窄行颈动脉内膜剥脱术后完整病例资料，围手术期监测头颈部CTA或DSA、经TCD、头部MRI，并动态监测患者收缩压，实现围手术期脑过度灌注综合征监测和有效干预。结果 57例患者经术后CTA/DSA证实颈动脉狭窄斑块完整切除，1例（1.75%）患者经临床症状及TCD、MRI影像学证实存在脑过度灌注综合征，出现头痛，手术对侧肢体肌力下降及认知功能下降，经积极控制血压及TCD动态监测，患者于术后7 d恢复正常。所有患者术后7 d无颈部血肿、声音嘶哑、颅内出血、脑缺血发作、植物生存及死亡患者。结论 围手术期加强监测是防治颈动脉内膜剥脱术后脑过度灌注综合征的重要方法，而控制血压是治疗脑过度灌注综合征的有效干预手段。
Abstract:
Abstract：Objective To investigate the perioperative intervention of brain hyperperfusion syndrome after carotid endarterectomy. Methods A retrospective analysis of 57 patients with carotid stenosis after carotid endarterectomy in our hospital from January to November 2017 was performed.Perioperative monitoring of head and neck CTA or DSA,TCD,and head MRI were performed during the perioperative period.The patient's systolic blood pressure was dynamically monitored to achieve perioperative monitoring of brain hyperperfusion syndrome and effective intervention.Results 57 patients underwent CTA/DSA to confirm the complete resection of carotid stenosis plaque.1 patient(1.75%)was confirmed by clinical symptoms,TCD and MRI to have cerebral hyperperfusion syndrome, headache,decreased muscle strength and cognitive function of the contralateral limbs.After active control of blood pressure and TCD monitoring,the patient recovered to normal 7 d after operation.All patients had no cervical hematoma,hoarseness,intracranial hemorrhage,cerebral ischemic attack,vegetative survival or death 7 d after operation.Conclusion Perioperative monitoring is an important method to prevent brain hyperperfusion syndrome after carotid endarterectomy.Control of blood pressure is an effective intervention for the treatment of brain hyperperfusion syndrome.

参考文献/References:


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更新日期/Last Update: 2018-09-15