颈内动脉狭窄急性血栓闭塞一例  

Analysis of diagnosis and treatment for acute thromboembolism occlusion caused by severe internal carotid artery stenosis: a case report

作　　者：张培丽[1] 孟璇[1] 王欣[1] 杨炀[1] 任军[2] 马东梅[1] 雷丹 Zhang Peili;Meng Xuan;Wang Xin;Yang Yang;Ren Jun;Ma Dong mei;Lei Dan(Department of Neurovascular Function Examination,the Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院神经血管功能检查科,730030 [2]兰州大学第二医院神经外科,730030

出　　处：《中国脑血管病杂志》2020年第6期330-332,共3页Chinese Journal of Cerebrovascular Diseases

摘　　要：超声检查发现颈动脉粥样硬化斑块破裂出血突发急性血栓形成导致颈内动脉闭塞。患者81岁,男性,因右眼视物不清行颈动脉超声检查,显示右侧颈内动脉(ICA)近段粥样硬化斑块致重度狭窄,斑块顶部纤维不连续,斑块内低至无回声特征(斑块内出血),检查过程中突然出现狭窄即后段ICA血流信号消失,诊断为急性血栓形成、ICA闭塞。通过临床给予“双抗”治疗并超声动态随访观察,3 d后血栓溶解,ICA再显重度狭窄特征,于入院第6天患者接受颈动脉内膜切除术血运重建治疗。颈动脉超声为颈动脉狭窄急性血栓形成的诊疗提供了重要的临床价值。Ultrasonography revealed that a case of acute internal carotid artery(ICA)occlusion caused by acute thrombosis due to severe stenosis and intraplaque hemorrhage.The patient is male and 81 years old with blurred vision in the right eye.Carotid artery ultrasound(CDU)showed that severe stenosis of right proximal ICA,the discontinuous fibrous cap at the top of atherosclerotic plaques,and intraplaque hemorrhage.Besides,the blood flow of the right distal ICA disappeared suddenly during the examination.Therefore,ICA occlusion caused by acute thrombosis was detected by CDU.The patient was followed-up day by day using ultrasonography and treated with dual antiplatelet therapy.Three days later,CDU showed that the right ICA was re-open but still accompanied by severe stenosis.The patient was treated by carotid endarterectomy for revascularization after six days of admission.According to this process of diagnosis and treatment,carotid ultrasound provides an important clinical role for the diagnosis,treatment,and follow-up of acute thrombosis with carotid artery stenosis.

关 键 词：颈内动脉狭窄 血管闭塞 急性血栓 超声检查 颈动脉内膜切除术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]