本文關鍵詞： 血流動力學 后交通動脈瘤 數(shù)字減影血管造影　出處：《大連醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：探討后交通動脈變異及頸內(nèi)動脈C1、C2段夾角情況引起的血流動力學改變與后交通動脈瘤形成的相關性。 方法：本研究選取2008年1月至2013年12月期間于大連醫(yī)科大學附屬第二醫(yī)院神經(jīng)內(nèi)科就診的且明確診斷為后交通動脈瘤的76例患者，隨機抽選同期住院的非顱內(nèi)動脈瘤患者78例，上述患者均行腦血管造影術檢查，其全腦血管造影資料及其他一般病史情況全部收集齊全。按照大腦后動脈供血類型的不同將后交通動脈分為三型：PO型、PI型及PII型。分別統(tǒng)計動脈瘤組及對照組三種類型后交通動脈的血管數(shù)，與對照組（非動脈瘤組）進行比較分析。同時統(tǒng)計動脈瘤組中三種后交通動脈類型各自發(fā)生動脈瘤的情況，三者行兩兩比較。根據(jù)腦血管造影片，對后交通動脈瘤患側及對側的頸內(nèi)動脈C1段、C2段夾角(即后交通動脈多發(fā)處附近)進行測量，并與對照組(非動脈瘤組)進行比較分析。應用統(tǒng)計學軟件SPSS17.0進行數(shù)據(jù)分析，計數(shù)資料采用卡方檢驗，計量資料采用t檢驗，P0.05表明差異有統(tǒng)計學意義，P0.01表明具有顯著統(tǒng)計學差異。 結果： 1.與對照組比較，后交通動脈瘤組異常后交通動脈（PI型及PII型）發(fā)生率高，差異有統(tǒng)計學意義（P0.05）。 2.在動脈瘤組中，P0型、PI型及PII型三種后交通動脈類型的動脈瘤發(fā)生率進行兩兩之間對比，PII型PI型PO型，P值均小于0.05，差別具有統(tǒng)計意義。 3.頸內(nèi)動脈C1、C2段平均夾角：后交通動脈瘤患側后交通動脈瘤對側對照組，差異有統(tǒng)計學意義（P0.05),但是動脈瘤患側中左、右側之間角度無差別（P0.05)。 結論： 1.異常后交通動脈（PI型及PII型）更易發(fā)生后交通動脈瘤，其中PII型后交通動脈最易發(fā)生動脈瘤，PI次之，發(fā)育正常的PO型后交通動脈最不易發(fā)生動脈瘤。 2.頸內(nèi)動脈C1段、C2段夾角大小與后交通動脈瘤的形成有相關性,該轉(zhuǎn)彎處的夾角較小一側形成后交通動脈瘤的可能性較大，但左、右側無明顯差別。
[Abstract]:Objective: to investigate the relationship between posterior communicating artery variation and the change of hemodynamics caused by the angle of C _ 1 C _ 2 segment of internal carotid artery and the formation of posterior communicating artery aneurysm. Methods: from January 2008 to December 2013, 76 patients with posterior communicating aneurysm were selected from Department of Neurology, second affiliated Hospital of Dalian Medical University. Seventy-eight patients with non-intracranial aneurysms in the same period were randomly selected and all of them were examined by cerebrovascular angiography. According to the blood supply type of posterior cerebral artery, the posterior communicating artery was divided into three types: type: PO. Pi type and PII type. The number of posterior communicating artery was counted in aneurysm group and control group. Compared with the control group (non-aneurysm group). At the same time statistics of the three types of posterior communicating artery aneurysm in the aneurysm group, the three groups were compared. According to the cerebral angiography film. The angle between C1 segment and C2 segment of the internal carotid artery (i.e. near the multiple sites of the posterior communicating artery) of the posterior communicating artery aneurysm was measured. And compared with the control group (non-aneurysm group), the statistical software SPSS17.0 was used to analyze the data, the counting data was chi-square test, and the measurement data was t-test. P0.05 indicated that the difference was statistically significant (P0.01). Results: 1.Compared with the control group, the incidence of Pi type and PII type of posterior communicating artery aneurysm in the patients with abnormal posterior communicating artery aneurysm was higher than that in the control group, and the difference was statistically significant (P 0.05). 2. The incidence of aneurysms of three types of posterior communicating artery (P0 and PII) in aneurysm group was compared with that in PII type Pi type PO group (P < 0 05). The difference has statistical significance. 3. The mean angle of C _ 1 C _ 2 segment of internal carotid artery: the contralateral control group of posterior communicating artery aneurysm, the difference was statistically significant (P 0.05), but the middle left side of the aneurysm. There was no difference in the angle between the right side (P 0.05). Conclusion: 1. Pi type and PII type of abnormal posterior communicating artery are more likely to occur posterior communicating artery aneurysm, among which PII type posterior communicating artery is the most likely to develop Pi aneurysm. The aneurysms of the posterior communicating artery are most difficult to occur in the normal development of PO type. 2. The angle between C1 segment and C2 segment of internal carotid artery was correlated with the formation of posterior communicating artery aneurysm. The angle at the corner was more likely to form the posterior communicating artery aneurysm, but there was no significant difference between the left and the right side.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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