合并颅内动脉瘤的烟雾病：临床特征、出血危险因素和治疗转归

发布时间：2018-05-18 11:46

本文选题：烟雾病 + 颅内动脉瘤　；参考：《安徽医科大学》2015年硕士论文

【摘要】：目的：探讨合并颅内动脉瘤的烟雾病的临床特征、出血危险因素和治疗转归。方法：对合并颅内动脉瘤的烟雾病患者的临床症状、动脉瘤位置和大小、治疗情况以及长期随访结果进行回顾性分析。结果：纳入34例合并颅内动脉的烟雾病患者(35个动脉瘤),其中颅内出血组22例(64.7%),非颅内出血组12例(35.3%)。在35个动脉瘤中,颅内出血组23个(主要动脉型11个,周围动脉型12个),非颅内出血组12个(主要动脉型11个,周围动脉型1个)；小型动脉瘤29个,中型动脉瘤6个(均为颅内出血组)。颅内出血组动脉瘤以周围动脉型为主,而非颅内出血组以主要动脉型为主,动脉瘤分型存在统计学差异(P=-0.024,P0.05)。颅内出血组除2例未行脑硬膜颞浅动脉血管融合术(Encephalo-duro-arterio-synangios, EDAS)外,其余患者以及非颅内出血组患者均行EDAS。3例周围动脉型动脉瘤造影复查时消失,1例动脉瘤栓塞术后复发,其余动脉瘤均无变化。长期随访显示,颅内出血组有1例患者在术后1年突发脑出血死亡,其余患者均未出现缺血性或出血性脑卒中；21例患者的改良Rankin量表评分改善。结论：不同临床表现的烟雾病患者合并的颅内动脉瘤分型存在差异；烟雾病患者合并的颅内动脉瘤多为小型动脉瘤,可暂不直接处理,而直接行EDAS,术后颅内动脉瘤可长期稳定,部分周围型动脉瘤可消失。
[Abstract]:Objective: to investigate the clinical features, bleeding risk factors and therapeutic outcome of moyamoya disease complicated with intracranial aneurysms. Methods: the clinical symptoms, location and size of aneurysms, treatment and long-term follow-up were retrospectively analyzed in patients with moyamoya disease complicated with intracranial aneurysms. Results: Thirty-four patients with moyamoya disease complicated with intracranial artery (35 aneurysms) were included, of which 22 cases were intracranial hemorrhage group (22 cases) and 12 cases were non-intracranial hemorrhage group (12 cases). Of the 35 aneurysms, 23 were intracranial hemorrhage (11 main arterial type, 12 peripheral artery type, 12 non-intracranial hemorrhage group) (11 main artery type, 1 peripheral artery type, 29 small aneurysms). There were 6 medium aneurysms (all intracranial hemorrhage group). The aneurysms of intracranial hemorrhage group were mainly of peripheral artery type, while that of non-intracranial hemorrhage group was mainly of main artery type. There was a statistical difference in the type of aneurysm between the two groups. In the intracranial hemorrhage group, except for 2 cases who were not treated with Encephalo-duro-arterio-synangioses (EDAS), all the other patients and the patients without intracranial hemorrhage underwent EDAS.3, and 1 case recurred after embolization. No change was found in the other aneurysms. Long-term follow-up showed that one patient in the intracranial hemorrhage group died of sudden intracerebral hemorrhage one year after operation, while the other 21 patients with ischemic or hemorrhagic stroke had not improved the score of modified Rankin scale. Conclusion: the types of intracranial aneurysms associated with moyamoya disease patients with different clinical manifestations are different, and the intracranial aneurysms associated with moyamoya disease patients are mostly small aneurysms, which can not be directly treated temporarily, but can be treated directly by EDAS.Intracranial aneurysms can be stable for a long time after operation. Some peripheral aneurysms may disappear.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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