不同引流静脉类型对支架治疗特发性颅内高压合并静脉窦狭窄疗效的影响  

Effect of Different Intracranial Venous Drainage Patterns on Stenting for Idiopathic Intracranial Hypertension with Venous Sinus Stenosis

作　　者：杨洪超 刘振强 莫大鹏[2] YANG Hongchao;LIU Zhenqiang;MO Dapeng(Department of Neurosurgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Neurointervention Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京朝阳医院神经外科,北京100020 [2]首都医科大学附属北京天坛医院神经介入科

出　　处：《中国卒中杂志》2022年第7期737-741,共5页Chinese Journal of Stroke

摘　　要：目的评价不同引流静脉类型对支架治疗特发性颅内高压合并静脉窦狭窄疗效的影响。方法连续入组2014年1月-2019年12月在首都医科大学附属北京天坛医院接受静脉窦支架置入术的特发性颅内高压患者,对病历资料进行回顾性分析。按照静脉引流类型分为横窦单侧引流组和横窦双侧引流组,比较2组的临床特点和术后1个月随访时头痛、视力障碍和视盘水肿等症状和体征的改善情况。结果115例患者接受了支架治疗,年龄18~62岁,中位年龄38(31~46)岁,女性90例(78.3%),其中横窦单侧引流组87例,横窦双侧引流组28例。横窦单侧引流组高脂血症发生率低于横窦双侧引流组(8.0%vs.21.4%,P=0.022),静脉窦狭窄率高于横窦双侧静脉引流组(79.2%vs.73.9%,P=0.018)。1个月随访结果显示,13例(11.3%)患者的头痛、视力障碍及视盘水肿等症状和体征消失,101例(87.8%)上述症状和体征有改善,1例(0.9%)症状和体征无改善或恶化。横窦单侧引流组比横窦双侧引流组视盘水肿体征的改善更明显(P=0.031),2组头痛和视力损害症状以及总体改善情况差异无统计学意义。结论静脉窦支架置入可改善特发性颅内高压患者的症状,横窦单侧静脉引流患者的视盘水肿体征改善较双侧引流患者更明显。Objective To evaluate the effect of different intracranial venous drainage patterns on stenting for idiopathic intracranial hypertension.Methods This retrospective study enrolled the consecutive patients with idiopathic intracranial hypertension who underwent venous sinus stent implantation in Beijing Tiantan Hospital from January 2014 to December 2019.According to intracranial venous drainage pattern,the patients were divided into the unilateral transverse sinus drainage(UTSD)group and bilateral transverse sinus drainage(BTSD)group.The clinical characteristics and 1-month prognosis of the two groups were compared,and the 1-month follow-up symptoms and signs after stenting were analyzed.Results A total of 115 patients received stenting,with a median age of 38(31-46)years(range:18-62 years)and 90 females(78.3%),87 cases in UTSD group and 28 cases in BTSD group.The percentage of hyperlipidemia in UTSD group was lower than that in BTSD group(8.0%vs.21.4%,P=0.022).The stenosis rate in UTSD group was higher than that in BTSD group(79.2%vs.73.9%P=0.018).The 1-month follow-up after stenting showed that symptoms and signs had improved in 101 patients(87.8%),headache,visual impairment and papilledema disappeared in 13 patients(11.3%),the original symptoms and signs had no improvement or deterioration in only one patient(0.9%).There were no statistical differences in improvement of headache(P=0.799)and visual impairment(P=0.104)and the overall improvement of symptoms(P=0.484)between the two groups.However,papilledema improved better in UTSD group than in BTSD group(P=0.031).Conclusions Venous sinus stenting can improve the symptoms of patients with idiopathic intracranial hypertension.The papilledema improved better in patients with unilateral transverse sinus drainage than in patients with bilateral transverse sinus drainage.

关 键 词：特发性颅内高压 静脉窦狭窄 支架 视力 视盘水肿 

分 类 号：R651.12[医药卫生—外科学]