烟雾病合并颈内动脉夹层动脉瘤的治疗探索  

Treatment Investigation of Moyamoya Disease Combined with Dissecting Aneurysm of Internal Carotid Artery

作　　者：苑兵舰 刘红林[1] 徐浩文[2] 刘志军[1] 陈小兵[1] 王贵聪 

机构地区：[1]河南大学淮河医院,河南开封475000 [2]郑州大学第一附属医院,河南郑州450000

出　　处：《世界最新医学信息文摘》2017年第31期50-51,共2页World Latest Medicine Information Electronic Version

摘　　要：目的探索烟雾病合并颈内动脉夹层动脉瘤动脉瘤的处理原则。方法回顾性分析2例我院DSA确诊的烟雾病合并颈内动脉夹层动脉瘤临床表现、影像学特点及治疗方法,其中1例药物保守治疗,定期随访,1例行颈内动脉夹层动脉瘤介入栓塞术。结果药物保守治疗例治疗前NIHSS评分为0分,治疗后无神经系统症状,mRS评分0分。治疗后1年、2年随访复查NIHSS评分分别为3分、3分,mRS评分分别为1分、1分。介入手术治疗1例,术前NIHSS评分为1分,出院NIHSS评分为1分,mRS评分为1分。术后6个月复查,NIHSS评分为0分,mRS评分为0分。结论 MMD合并颈内动脉夹层动脉瘤的病情复杂,要高度重视。颈内动脉夹层动脉瘤存在自愈的可能性,但药物保守治疗只能延缓MMD的进展,不能阻止。在不破坏MMD重新建立的侧枝血流的情况下,血管介入治疗方法无疑是一种很好的选择。Objective to explore treatment principle of moyamoya disease combined with dissecting aneurysm of internal carotid artery. Methods review and analyze clinical manifestation, imaging features and treatment methods of 2 cases moyamoya disease combined with dissecting aneurysm of internal carotid artery diagnosed by DSA in our hospital, 1 case was treated with medicine conservative therapy with regular follow-up, the other case with interventional embolization of internal carotid artery dissecting aneurysm. Results before treatment of 1 case of medicine conservative therapy, NIHSS score was 0, no neurological symptoms after treatment, mRS score was 0. 1 year and 2 years follow-up after treatment showed NIHSS scores were 3, 3, mRS score was 1 and 1 respectively. For 1 case of interventional therapy, preoperative NIHSS score was 1, and NIHSS score was 1 while discharging from hospital, and mRS score was 1. Review after 6 months showed NIHSS score was 0, and mRS score was 0. Conclusion MMD combined with internal carotid artery dissecting aneurysm is a complicated disease, which should be attached great importance to. Dissecting aneurysm of internal carotid artery has possibility of self-healing, but medicine conservative treatment can only delay progress of MMD, not stop it. under condition of not damaging MMD＇s re establishing collateral blood flow, vascular interventional therapy is undoubtedly a good choice for it.

关 键 词：烟雾病 夹层动脉瘤 支架辅助栓塞术 

分 类 号：R543.31[医药卫生—心血管疾病]