创伤性颅颈部动脉夹层的诊治进展  

Diagnosis and treatment of traumatic craniocervical arterial dissection: an update

作　　者：马佩佩 左乔[1] 方亦斌[1] 刘建民[1] MA Pei-pei;ZUO Qiao;FANG Yi-bin;LIU Jian-min(Stroke Center,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)长海医院脑血管病中心,上海200433

出　　处：《第二军医大学学报》2021年第2期166-170,共5页Academic Journal of Second Military Medical University

基　　金：上海市临床重点专科项目(shslczdzk06101).

摘　　要：创伤性颅颈部动脉夹层(TCAD)是在外伤性因素作用下颅颈部动脉内膜撕裂,血液流入血管壁内导致壁间血肿形成或管腔移位。其最常引发的临床病变是缺血性脑卒中,但往往因缺乏首发症状被忽视。影像学检查对TCAD的诊断有重要意义,其中计算机断层扫描血管造影(CTA)为首选检查,当CTA无法确诊时可行数字减影血管造影(DSA)。TCAD目前主要的治疗方法包括抗栓治疗和手术治疗。近年来,以血管内治疗为主的新型治疗手段不断涌现,相比传统开放手术血管内治疗操作难度小、风险低、并发症少。本文就TCAD诊断和治疗的相关研究进展进行综述。Traumatic craniocervical arterial dissection(TCAD)refers to a traumatic rupture of the intima of craniocervical artery,resulting in the formation of intramural hematoma or displacement of the lumen.Ischemic stroke is the most common lesion,and often overlooked due to the lack of onset symptoms.Imaging examination is of great value in the diagnosis of TCAD,and computed tomography angiography(CTA)is a preferred method.Digital substraction angiography(DSA)is feasible when the diagnosis cannot be confirmed by CTA.The main treatments of TCAD were antithrombotic therapy and surgery.In recent years,new therapeutic options,mainly endovascular treatment,have been developed.Compared with traditional open surgery,endovascular treatment has less operational difficulty,lower risk,and less complications.This paper reviews the progress in the diagnosis and treatment of TCAD.

关 键 词：创伤 夹层 颈动脉 椎动脉 诊断 治疗 

分 类 号：R654.34[医药卫生—外科学]