發(fā)布時間：2018-09-01 13:23

【摘要】：目的：探討頸內(nèi)動脈重度狹窄或閉塞的缺血性腦卒中患者其側(cè)支循環(huán)與臨床癥狀的關(guān)系。 方法：對110例單側(cè)頸內(nèi)動脈(ICA)重度狹窄或閉塞的急性缺血性腦卒中患者,行經(jīng)顱多普勒(transcranial doppler ultrasonography, TCD)檢查,了解側(cè)支循環(huán)開放情況。根據(jù)TCD檢測到的前交通動脈(ACOA).后交通動脈(PCOA)、眼動脈(OA)的代償情況,將患者分為單純ACOA開放組、單純PCOA開放組、單純OA開放組、ACOA合并PCOA開放組及無側(cè)支循環(huán)開放組5組,比較各組入院時和住院2周時美國國立衛(wèi)生研究院卒中量表(NIHSS)評分,以及入院時和6個月時改良Rankin評分(mRS)。 結(jié)果：(1)110例患者中ACOA開放47例,占全部患者的43%。PCOA開放38例,占35%；OA開放28例,占25%。(2)無側(cè)支循環(huán)開放組治療前后NIHSS評分、mRS評分無明顯差異(P0.05)。(3)治療2周時,ACOA開放組、PCOA開放組、ACOA合并PCOA開放組NIHSS評分較OA開放組、無側(cè)支循環(huán)代償組明顯降低(P0.05)。(3)ACOA合并PCOA開放組NIHSS評分明顯低于單純ACOA組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)6個月隨訪時ACOA開放組、PCOA開放組、ACOA合并PCOA開放組mRS評分明顯低于OA開放組和無側(cè)支循環(huán)代償組(P0.05)。 結(jié)論：單側(cè)頸內(nèi)動脈重度狹窄或閉塞的缺血性腦卒中患者,前交通動脈開放是顱內(nèi)側(cè)支循環(huán)開放的主要途徑,Willis環(huán)側(cè)支開放類型與臨床癥狀、預(yù)后密切相關(guān)。
[Abstract]:Objective: to investigate the relationship between collateral circulation and clinical symptoms in ischemic stroke patients with severe stenosis or occlusion of internal carotid artery. Methods: Transcranial Doppler (transcranial doppler ultrasonography, TCD) examination was performed in 110 patients with acute ischemic stroke with severe stenosis or occlusion of unilateral internal carotid artery (ICA). (ACOA). Of anterior communicating artery detected by TCD The (OA) compensation of posterior communicating artery (PCOA),) ophthalmic artery was divided into five groups: ACOA open group, PCOA open group, OA open group combined with PCOA open group and open collateral circulation group. The (NIHSS) score of the National Institutes of Health Stroke scale at admission and 2 weeks after hospitalization, and the modified Rankin score (mRS). At admission and 6 months were compared among the groups. Results: (1) among the 110 patients, 47 cases were open to ACOA, 38 cases were open to 43%.PCOA, and 28 cases were open to 35 cases of OA. (2) there was no significant difference in NIHSS score and Mrs score before and after treatment in the open group without collateral circulation (P0.05). (3). At 2 weeks after treatment, the NIHSS score of the open group with PCOA in the open group was higher than that in the open group of OA. The score of NIHSS in ACOA combined with open PCOA group was significantly lower than that in simple ACOA group (P0.05). (3). The difference was statistically significant (P0.05). (4) after 6 months follow-up, the mRS score of ACOA open group was significantly lower than that of OA open group and non-collateral circulation compensatory group (P0.05). Conclusion: in ischemic stroke patients with severe stenosis or occlusion of unilateral internal carotid artery, open anterior communicating artery is the main way to open intracranial collateral circulation. The type of open collateral of Willis is closely related to clinical symptoms and prognosis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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