CAJ | 학술논문

目的探讨创伤性颅底动脉损伤的临床特征及诊疗规范. 方法回顾315例创伤性颅底动脉损伤患者的临床资料,按颅底动脉解剖部位和血管损伤的病理类型进行分类,根据患者全身状况、受累动脉的结构和血流动力学特点、脑组织血供改变以及侧支循环情况综合决定患者的治疗策略和方法,在此基础上分析显微外科手术、血管内治疗以及非手术治疗的临床预后,利用改良的Rankin评分(mRS)对患者进行随访,观察不同类型和不同治疗方法的患者预后情况.结果本组血管内治疗269例,显微外科手术18例,单纯非手术治疗28例.其中283例患者获得随访,时间3个月～15年,mRS 0 ～2分269例,mRS 3 ～5分11例,mRS 6分(临床死亡)3例.结论规范的诊治流程是提高创伤性颅底动脉损伤救治成功率的关键.
목적 탐토창상성로저동맥손상적림상특정급진료규범. 방법 회고315례창상성로저동맥손상환자적림상자료,안로저동맥해부부위화혈관손상적병리류형진행분류,근거환자전신상황、수루동맥적결구화혈류동역학특점、뇌조직혈공개변이급측지순배정황종합결정환자적치료책략화방법,재차기출상분석현미외과수술、혈관내치료이급비수술치료적림상예후,이용개량적Rankin평분(mRS)대환자진행수방,관찰불동류형화불동치료방법적환자예후정황.결과 본조혈관내치료269례,현미외과수술18례,단순비수술치료28례.기중283례환자획득수방,시간3개월～15년,mRS 0 ～2분269례,mRS 3 ～5분11례,mRS 6분(림상사망)3례.결론 규범적진치류정시제고창상성로저동맥손상구치성공솔적관건.
Objective To summarize the clinical features of traumatic basicranial artery injury and standardize the diagnosis and treatment procedures.Methods Medical records of 315 consecutive patients diagnosed as traumatic basicranial artery injury were retrospectively reviewed.The patients were categorized according to the location and pathological subtypes of the injury.Treatment strategies were based on patients' general situation,structure of the involved arteries,hemodynamic characteristics,alterations of the cerebral blood supply and collateral circulation status.Then the patients were evaluated to help realizing the prognosis of microsurgery,intravascular treatment and conservative treatment respectively.The modified Rankin score (mRS) was used to measure the clinical outcome at follow-up.Results There were 269 patients managed with intravascular treatment,18 microsurgery and 28 conservative treatment.A total of 283 patients were available to a follow-up of 3 months to 15 years.mRS was 0-2 in 283 patients,3-5 in 11 patients and 6 in 3 patients.Conclusion Key to successful treatment of traumatic basicranial artery injury depends on standardized diagnosis and treatment procedures.