CAJ | 학술논문

目的评价卵圆孔未闭(PFO)封堵术对伴有PFO的偏头痛患者的疗效及安全性.方法收集吉林大学第一医院神经内科2010年5月到201 1年1 1月因偏头痛行经颅多普勒超声发泡试验检查结果为阳性,并于本院心外科行经皮PFO封堵术的患者23例作为研究对象.术后一段时间后,复查患者发泡试验及经胸壁超声心动图以了解手术效果,通过对患者治疗前后的头痛影响测验(HIT)-6调查问卷进行回顾性统计学分析,并了解术后并发症情况,对其进行疗效及安全性的评估.结果 23例患者均手术成功,在院及随访期间均无术后并发症.全部患者均接受了电话随访,时间48 ～ 542(247±145)d,HIT-6得分(分)与术前(61 ±8)相比,术后(51±9)头痛对生活的影响程度明显改善(=4.80,P＜0.05).其中6例先兆型偏头痛患者与术前(69±4)相比,术后(51 ±3)头痛对生活的影响程度有明显改善(t =6.80,P＜0.05);17例无先兆型偏头痛患者与术前(60±8)相比,术后(52±10)头痛对生活的影响程度有明显改善(t=3.77,P＜0.05).8例术前行头CT或头MRI检查存在神经系统事件(如脑梗死灶、脑缺血灶等)患者与术前(58±10)相比,术后(49±7)其残疾影响程度有明显改善(=2.49,P＜0.05).结论对伴有PFO的严重偏头痛患者,给予PFO封堵术治疗可以减轻头痛对患者生活质量的影响,手术方法安全性高,效果良好.
목적 평개란원공미폐(PFO)봉도술대반유PFO적편두통환자적료효급안전성.방법 수집길림대학제일의원신경내과2010년5월도201 1년1 1월인편두통행경로다보륵초성발포시험검사결과위양성,병우본원심외과행경피PFO봉도술적환자23례작위연구대상.술후일단시간후,복사환자발포시험급경흉벽초성심동도이료해수술효과,통과대환자치료전후적두통영향측험(HIT)-6조사문권진행회고성통계학분석,병료해술후병발증정황,대기진행료효급안전성적평고.결과 23례환자균수술성공,재원급수방기간균무술후병발증.전부환자균접수료전화수방,시간48 ～ 542(247±145)d,HIT-6득분(분)여술전(61 ±8)상비,술후(51±9)두통대생활적영향정도명현개선(=4.80,P＜0.05).기중6례선조형편두통환자여술전(69±4)상비,술후(51 ±3)두통대생활적영향정도유명현개선(t =6.80,P＜0.05);17례무선조형편두통환자여술전(60±8)상비,술후(52±10)두통대생활적영향정도유명현개선(t=3.77,P＜0.05).8례술전행두CT혹두MRI검사존재신경계통사건(여뇌경사조、뇌결혈조등)환자여술전(58±10)상비,술후(49±7)기잔질영향정도유명현개선(=2.49,P＜0.05).결론 대반유PFO적엄중편두통환자,급여PFO봉도술치료가이감경두통대환자생활질량적영향,수술방법안전성고,효과량호.
Objective To evaluate the clinical effect and safety of percutaneous closure of patent foramen ovalein treatment of migraine.Methods We studied 23 patients with migraine who were tested positive in Contrast Transcranial Doppler (TCDc) at the Department of Neurology in Bethune First Hospital of Jilin University between 2010 May and 2011 November.Procedures of transcatheterclosure of patent foramen ovale were performed at Department of Cardiovascular Surgery.At varied time points post-surgery,the patients were re-examined by TCDc and transthoracic echocardiograph (TTE) and followed up by phone interviewed with Headache Impact Test-6 (HIT-6) questionnaire to elevate improvement of migraine.The data was analyzed statistically.Results Percutaneous closure was successful in all patients without major long-term side-effects.At follow-ups at 48-542 days ((247 ± 145) days) post-surgery,the scores of HIT-6 were reduced to 38-70 (51 ± 9),compared to the pre-operative scores of 42-76 (61 ± 8).Disability by migraine had significantly improved (t =4.80,P ＜ 0.05).In 6 patients with migraine with aura,the scores of HIT-6 were reduced to 46-56 (51 ± 3),from preoperative scores of 63-76 (69 ± 4) and their disability affected by migraine had significantly improved (t =6.80,P ＜0.05).In 17 patients with migraine without aura,the scores of HIT-6 after surgery were reduced to 36-70 (52-10) from the preoperative scores of 42-69 (60 ± 8) and disability affected by migraine in this group had significantly improved (t =3.77,P ＜0.05).Among 18 patients having MRI or CT examination before the operation,8 patients had neurological events (such as cerebral infarction,cerebral ischemia) with average age of (44 ± 7) years old.In this group,disability affected by migraine had significantly improved (the HIT-6 scores:49 ± 7 vs 58 ± 10,t =2.49,P ＜ 0.05).Conclusion Percutaneous closure of PFO showed significant improvement in migraine treatment and it is a safe procedure.