中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2014年
1期
65-68
,共4页
苏世星%段传志%吾太华%张炘%赖凌峰%何旭英%李西锋%顾大群%刘彦超
囌世星%段傳誌%吾太華%張炘%賴凌峰%何旭英%李西鋒%顧大群%劉彥超
소세성%단전지%오태화%장흔%뢰릉봉%하욱영%리서봉%고대군%류언초
脑动静脉畸形%血管内栓塞%术后出血%危险因素
腦動靜脈畸形%血管內栓塞%術後齣血%危險因素
뇌동정맥기형%혈관내전새%술후출혈%위험인소
Cerebral arteriovenous malformations%Endovascular embolization%Hemorrhage%Risk factor
目的 探讨脑动静脉畸形栓塞术后颅内出血的危险因素、出血后的处理措施及疗效. 方法 回顾性分析南方医科大学珠江医院自2002年1月至2012年6月收治的263例行血管内栓塞治疗脑动静脉畸形患者的临床资料,采用非条件性Logistic回归分析其栓塞术后颅内出血的危险因素,并总结栓塞术后出血的治疗策略,对术后所有出血的患者进行定期临床及影像学随访,评估该治疗策略的临床疗效. 结果 本组共有17例患者发生栓塞术后颅内出血.单次栓塞面积≥36.5％(OR=19.269; 95％ CI=1.283～289.299,P=0.032)、既往高血压病史(OR=7.962,95％ CI=1.121～56.567,P=0.038)是栓塞术后颅内出血的危险因素. 结论 单次面积栓塞≥36.5％和既往高血压病史可增加脑动静脉畸形栓塞术后颅内出血的风险,术后严格降压至基础血压的2/3且至少72 h是减少栓塞术后继发颅内出血的关键.
目的 探討腦動靜脈畸形栓塞術後顱內齣血的危險因素、齣血後的處理措施及療效. 方法 迴顧性分析南方醫科大學珠江醫院自2002年1月至2012年6月收治的263例行血管內栓塞治療腦動靜脈畸形患者的臨床資料,採用非條件性Logistic迴歸分析其栓塞術後顱內齣血的危險因素,併總結栓塞術後齣血的治療策略,對術後所有齣血的患者進行定期臨床及影像學隨訪,評估該治療策略的臨床療效. 結果 本組共有17例患者髮生栓塞術後顱內齣血.單次栓塞麵積≥36.5％(OR=19.269; 95％ CI=1.283～289.299,P=0.032)、既往高血壓病史(OR=7.962,95％ CI=1.121～56.567,P=0.038)是栓塞術後顱內齣血的危險因素. 結論 單次麵積栓塞≥36.5％和既往高血壓病史可增加腦動靜脈畸形栓塞術後顱內齣血的風險,術後嚴格降壓至基礎血壓的2/3且至少72 h是減少栓塞術後繼髮顱內齣血的關鍵.
목적 탐토뇌동정맥기형전새술후로내출혈적위험인소、출혈후적처리조시급료효. 방법 회고성분석남방의과대학주강의원자2002년1월지2012년6월수치적263례행혈관내전새치료뇌동정맥기형환자적림상자료,채용비조건성Logistic회귀분석기전새술후로내출혈적위험인소,병총결전새술후출혈적치료책략,대술후소유출혈적환자진행정기림상급영상학수방,평고해치료책략적림상료효. 결과 본조공유17례환자발생전새술후로내출혈.단차전새면적≥36.5％(OR=19.269; 95％ CI=1.283～289.299,P=0.032)、기왕고혈압병사(OR=7.962,95％ CI=1.121～56.567,P=0.038)시전새술후로내출혈적위험인소. 결론 단차면적전새≥36.5％화기왕고혈압병사가증가뇌동정맥기형전새술후로내출혈적풍험,술후엄격강압지기출혈압적2/3차지소72 h시감소전새술후계발로내출혈적관건.
Objective To identify the risk factors of hemorrhage after endovascular therapy of cerebral arteriovenous malformations (cAVMs),and illustrate the prevention and management on this event as well as its postembolization outcomes evaluation for the purpose of guiding the clinical prevention and treatment decision in the future for hemorrhage after endovascular therapy of cAVMs.Methods We retrospectively reviewed the clinical records and images of 263 patients with cAVMs.The risk factors of hemorrhage after endovascular therapy of cAVMs were studied by using multivariate logistic regression for guiding the treatment strategy.All patients who suffered from hemorrhage after endovascular therapy of cAVMs received clinical and angiographic follow-up for outcome evaluating.Results Intracerebral hemorrhages occurred in 18 patients.A partial AVM reduction of ≥36.5％ (OR=19.269,95％ CI:1.283-289.299,P=0.032) and hypertension (OR=7.962,95％ CI=1.121-56.567,P=0.038) were considered as risk factors for hemorrhage after endovascular therapy of cAVMs.Conclusions Patients who receives a partial AVM reduction of ≥36.5％ in one session and who have hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.Arterial blood pressure maintaines at 2/3 of baseline for at least 72 hours after embolization are confirmed to be the essential strategy,which would decrease the hemorrhage rate after endovascular therapy of cAVMs.
