[1]刘俊 唐朝芳.急性主动脉夹层合并脑梗死患者的临床特点和外科治疗效果[J].卒中与神经疾病杂志,2019,26(03):330-333.[doi:10.3969/j.issn.1007-0478.2019.03.018]
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急性主动脉夹层合并脑梗死患者的临床特点和外科治疗效果()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第26卷
期数:
2019年03期
页码:
330-333
栏目:
论 著
出版日期:
2019-06-25

文章信息/Info

文章编号:
1007-0478(2019)03-0330-04
作者:
刘俊 唐朝芳
642150 四川省隆昌市人民医院神经外科
关键词:
急性主动脉夹层 脑梗死 临床特点 手术干预 预后
分类号:
R543.1 R743.33
DOI:
10.3969/j.issn.1007-0478.2019.03.018
文献标志码:
A
摘要:
目的 探讨急性主动脉夹层(AAD)合并脑梗死的临床特征及手术干预的效果和预后。方法 选取2011年2月～2017年9月接受了手术治疗AAD的68例患者,其中13例患者(19.1%)出现脑梗死,收集合并脑梗死患者的临床特征、神经系统症状、计算机断层扫描表现、从发作到手术的间隔、手术细节(手术方法、动脉插管部位、脑保护方法)等资料。结果 68例AAD患者中A型41例,B型27例。A型患者中晕厥、纵隔变宽、脉搏缺损和主动脉分支血管受累及院内死亡人数所占比例较高(P<0.05),而B型患者表现出较高的吸烟率(P<0.05)。与非合并脑梗死患者比较,合并脑梗死组患者的年龄显著增大且具有经典型夹层人数的所占比例更多(P<0.05)。术前大部分患者表现出短暂性脑缺血发作、偏瘫、昏睡、抽搐等症状,胸部CT检查证实所有患者均存在主动脉夹层,超声检查证实1号、4号、6号、9号和14号患者颈动脉狭窄或闭塞。4例术后昏迷患者均因严重脑损伤死亡,死亡原因为广泛性右半球脑梗死伴或不伴出血,而大多数存活者也存在右半球脑梗死。结论 AAD合并脑梗死患者的早期诊断是困难的,脑梗死症状可能完全主导临床表现,除了典型的胸痛和胸片中纵隔增宽外,各种神经缺损症状包括左侧偏瘫、意识障碍、抽搐可能都在提示潜在的AAD。

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更新日期/Last Update: 2019-06-25