颈总动脉闭塞性病变的侧支血流代偿分型研究  

Classification of collateral blood compensation pathways in patients with common carotid artery occlusive disease

作　　者：刘洋[1] 王佳楠 周洁信[1] 王拓一[1] Liu Yang;Wang Jianan;Zhou Jiexin;Wang Tuoyi(Cerebrovascular Stenosis Diagnosis and Interventional Treatment Center, Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China;Department of Neurology, Chinese People's Liberation Army Rocket Army Characteristic Medical Center, Beijing 100088, China)

机构地区：[1]齐齐哈尔医学院附属第二医院脑血管狭窄诊断与介入治疗中心,齐齐哈尔161006 [2]解放军火箭军特色医学中心神经内科,北京100088

出　　处：《中华神经医学杂志》2019年第5期470-474,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨颈总动脉闭塞性病变的侧支血流代偿分型及其特点。方法回顾性收集齐齐哈尔医学院附属第二医院脑血管狭窄诊断与介入治疗中心自2016年5月至2018年9月诊治的20例颈总动脉闭塞性病变患者的血流动力学及影像学资料,依据患者有无颈内动脉窃血及侧支循环对其侧支血流代偿进行分型。结果20例患者中11例存在颈内动脉窃血;17例存在侧支循环,其中前交通动脉侧支10支,后交通动脉侧支9支,大脑后动脉-大脑中动脉软脑膜吻合侧支11支,眼动脉侧支8支。患者的侧支血流代偿分型可分为3型,其中Ⅰ型为单纯颈内动脉窃血,共3例;Ⅱ型为颈内动脉窃血+侧支循环,共8例;Ⅲ型为单纯侧支循环,共9例。结论部分颈总动脉闭塞性病变患者的侧支血流代偿中存在颈内动脉窃血途径。Objective To explore the classification of collateral blood compensation pathways and collateral blood compensation characteristics in patients with common carotid artery occlusive disease. Methods The hemodynamic and imaging data of 20 patients with common carotid artery occlusive disease, admitted to our hospital from May 2016 to September 2018, were collected. The patients were classified according to whether they had internal carotid artery stealing and collateral circulation compensating for collateral flow. Results Internal carotid artery hematoma was found in 11 of the 20 patients;there was collateral circulation in 17 patients, including 10 branches of the anterior communicating artery, 9 branches of the posterior communicating artery, 11 branches of the posterior cerebral artery-middle cerebral arterial pia anastomosis, and 8 branches of the ocular artery. There were three types of collateral blood compensation pathways to be discovered in the 20 patients with common carotid artery occlusive disease;type I (n=3) was the collateral blood compensation pathway with simple internal carotid artery stealing, type II (n=8) was the collateral blood compensation pathway with internal carotid artery stealing and collateral circulation, and type III (n=9) was the collateral blood compensation pathways with simple collateral circulation. Conclusion In some patients with common carotid artery occlusion, the internal carotid artery stealing route exists in the collateral flow compensation.

关 键 词：颈总动脉 闭塞性病变 颈内动脉窃血 侧支循环 

分 类 号：R743.3[医药卫生—神经病学与精神病学]