球囊闭塞试验在颈内动脉永久闭塞术决策中的参考作用  

Role of balloon occlusion test in the treatment of permanent internal carotid artery occlusion

作　　者：黎劭学[1] 陈锦华[1] 张燕婷[1] 邹志敏[1] 李颖彬[1] 刘诗万 蔡军[1] 陈锐聪[1] 白小欣[1] 

机构地区：[1]广东省中医院大学城医院神经外科,广东广州510006

出　　处：《局解手术学杂志》2016年第8期603-605,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨颈内动脉球囊闭塞试验结果与Willis环代偿的关系,以及该试验在颈内动脉永久闭塞术决策过程中的参考作用。方法统计2009年10月至2015年6月我院49名患者52例(侧)颈内动脉球囊闭塞试验的临床资料,分析前交通动脉和后交通动脉出现率与试验阳性率的关系。结果前交通动脉出现率为97.9%,一侧后交通动脉出现率为82.7%。球囊闭塞试验阴性占比92.3%,均有前交通动脉;阳性占比7.7%,其中2例右侧受试侧优势大脑前动脉并同侧后交通动脉缺如,1例左侧受试侧优势大脑前动脉并左侧后交通动脉缺如,1例前交通动脉和后交通动脉均缺如。结论拟闭塞颈内动脉但前交通动脉缺如的病例有必要明确其血流代偿方式;对于Willis环完整的病例实施永久闭塞导致的缺血风险较低。Objective To investigate the relation between the balloon occlusion test （BOT） and the anatomy of the circle of Willis （CW） , and to explore the role of balloon occlusion test in the treatment of internal carotid artery permanent occlusion. Methods Selected the clinical data of 49 patients （52 sides） who had BOT in our hospital from October 2009 to June 2015, and analyzed the relationship be- tween the occurrence rate of anterior communicating artery （AcoA） / posterior communicating artery （PeoA） and the positive rate of BOT retrospectively. Results The occurrence rate of the AeoA was 97.9% , and the occurrence rate of PeoA in one side was 82.7%. Negative rate BOT accounted for 92.3% and AcoA occurred in all, while the positive rate accounted for 7.7% , including 2 cases of right superior arteria eerebri anterior combined with ipsilateral PcoAs absence, 1 case of left superior arteria cerebri anterior combined with ipsilateral PcoAs absence, and 1 case of AcoA and PcoAs absence. Conclusion Before the permanent occlusion of the internal carotid artery, it＇ s necessary to clarify the redistribution of the compensatory way of blood flow in the AcoA-absent cases. Implementing permanent occlusion for cases with complete circle of Willis would cause less ischemic risk.

关 键 词：球囊闭塞试验 WILLIS环 颈内动脉闭塞 

分 类 号：R651.12[医药卫生—外科学]