本文選題：腦動靜脈畸形　切入點：栓塞治療　出處：《昆明醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：[目的]觀測腦動靜脈畸形(BAVM)栓塞治療前后各時期腦灌注的變化。根據(jù)腦灌注變化情況尋求針對性臨床治療措施,降低并發(fā)癥發(fā)生率。[方法]回顧性分析21例行BAVM栓塞術患者資料,所有患者于術前3天內(nèi)、術后經(jīng)ICU監(jiān)護平穩(wěn)過渡且血壓平穩(wěn)后、術后3～6個月復查時行腦MR PWI檢查。通過對區(qū)域腦血流量(rCBF)、區(qū)域腦血容量(rCBV)、區(qū)域平均通過時間(rMTT)及區(qū)域達峰時間(rTTP)的檢測,了解患者各時期腦灌注變化情況,探究如何改善臨床治療。[結(jié)果]栓塞術前BAVM供血動脈的供血區(qū)域內(nèi)rCBF、rCBV較健側(cè)半球低,rMTT時間延長;術后ICU監(jiān)護結(jié)束時患側(cè)rCBF、rCBV較健側(cè)增高,rMTT時間縮短;術后3～6個月復查時健患側(cè)腦血流灌注參數(shù)無明顯差異。[結(jié)論]MR PWI檢查可觀測BAVM栓塞術引起的腦灌注變化,可為改善治療提供依據(jù)。栓塞術引起的腦灌注變化為短期的改變,最終患側(cè)腦灌注趨于正常。臨床需重點防治正常灌注壓突破(NPPB)導致的并發(fā)癥。
[Abstract]:[objective] to observe the changes of cerebral perfusion before and after cerebral arteriovenous malformation (BAVM) embolization. To reduce the incidence of complications. [methods] 21 patients with BAVM embolization were retrospectively analyzed. All patients underwent ICU monitoring and stable blood pressure within 3 days before operation. The regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional mean transit time (rMTT) and regional peak time (rTTP) were measured at 3 ~ 6 months after operation. To explore how to improve the clinical treatment. [results] before embolization, the time of rCBFU rCBV in the blood supply area of BAVM was longer than that in the normal hemispheres, and the time of rCBFV in the affected side was shorter than that in the normal side at the end of ICU monitoring. There was no significant difference in cerebral perfusion parameters between 3 ~ 6 months after operation. [conclusion] Mr PWI can be used to observe the changes of cerebral perfusion induced by BAVM embolization, and to provide evidence for the improvement of treatment. The changes of cerebral perfusion caused by embolization are short-term changes. In the end, the cerebral perfusion of the affected side tended to be normal, and the complications caused by the breakthrough of normal perfusion pressure (NPPB) should be prevented and treated clinically.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.4;R445.2

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