颈动脉支架成形术后脑高灌注综合征与高灌注现象4例报告  

4 cases of cerebral hyperperfusion syndrome and cerebral hyperperfusion phenomenon following carotid artery stenting

作　　者：刘胜达[1] 吕春风[1] 袁丹[2] 巩忠[2] 刘洁[2] 李郁芳[3] 

机构地区：[1]北京航天总医院高压氧科,北京100076 [2]北京航天总医院神经内科 [3]北京航天总医院神经介入科

出　　处：《临床急诊杂志》2015年第5期382-386,共5页Journal of Clinical Emergency

摘　　要：目的:探讨颈动脉支架术后脑高灌注综合征(CHS)的发病机制、临床表现和预防治疗方法,加深临床对颈动脉支架术(CAS)后脑高灌注综合征认识。方法:回顾性分析我院颈动脉支架成形术后3例脑高灌注综合征和1例高灌注现象患者的临床资料,包括支架植入前后血压管理、临床特征、影像数据包括头部CT和数字减影动脉造影术(DSA)检查,经颅多普勒超声(TCD)监测术前术后大脑中动脉收缩期峰值流速,以及临床处理和临床结局。结果:4例患者经严格控制血压、脱水降颅压、加强监护后,脑血流速度恢复正常,脑高灌注临床症状缓解。结论:术前严格评估高危因素、术前术后严格控制血压、TCD严密观察脑血流是预防脑高灌注综合征的有效措施。Objective： To discuss the pathogenesis, clinical manifestation and prevention and management of cerebral hyperperfusion syndrome （CHS） following carotid angioplasty and stenting （CAS）. Method： We retro- spectively reviewed the clinical data of 3 cases of hyperperfusion syndrome and a case of hyperperfusion phenome- non following CAS,including blood pressure management before and after stenting, monitoring of cerebral blood flow by TCD,the treatment and outcome of CHS. Result：Via strictly blood pressure control,dehydration for reduc- ing intracranial pressure,the cerebral blood flow resumed normal,the clinical symptoms of CHS relieved. Conclu- sion：Strictly assessment risk factors before CAS,strictly blood pressure control before and after CAS,TCD moni- tor cerebral blood flow are helpful for preventing CHS.

关 键 词：脑高灌注综合征 高灌注现象 颈动脉支架成形术 经颅多普勒超声监测 预防和处理 

分 类 号：R743[医药卫生—神经病学与精神病学]