以Wallenberg综合征起病的椎动脉颅外段闭塞介入治疗探讨  

Interventional treatment of vertebral artery occlusion with Wallenberg syndrome

作　　者：袁兴运 陈万红 鱼丽萍 姚力 Xingyun Yuan;Wanhong Chen;Liping Yu;Li Yao(Department of Neurology,the First People's Hospital of Xianyang,Xianyang 712000,China;Department of Neurology,XD Group Hospital,Xi'an 710077,China)

机构地区：[1]咸阳市第一人民医院神经内科,陕西咸阳712000 [2]西电集团医院神经内科,西安710077

出　　处：《中华脑血管病杂志（电子版）》2023年第4期394-399,共6页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：陕西省中医药管理局2021-2022年度科研项目(2021-ZZ-LC033);中国卒中学会脑血管病全程管理项目一启航基金(202001)。

摘　　要：目的探讨介入治疗对椎动脉颅外段闭塞引起的Wallenberg综合征(又称延髓背外侧综合征)的安全性和有效性。方法收集2022年9月至2023年1月在咸阳市第一人民医院(4例)和西电集团医院(2例)急诊介入再通的6例椎动脉颅外段闭塞引起的Wallenberg综合征患者的临床资料,回顾性分析患者的基本资料、术前症状、闭塞血管、血管再通分级、手术并发症、24 h临床症状及体征变化、90 d改良Rankin量表(mRS)评分等情况。结果6例发病时间:最短5 h,最长5 d;责任血管均为左侧椎动脉(VA);6例患者VA均获得开通,所有患者术后24 h头晕/眩晕等主观症状均明显减轻,1例在开通过程中发生血栓逃逸,采用中间导管抽吸后无症状。6例90 d mRS评分均预后良好。结论对于VA闭塞起始处急性闭塞引起的Wallenberg综合征急诊介入开通治疗安全可行,可明显减轻患者主观症状。Objective To explore the safety and efficacy of interventional therapy for the Wallenberg syndrome(dorsolateral medullary syndrome)caused by extracranial vertebral artery occlusion.Methods The clinical data of 6 patients with Wallenberg syndrome caused by extracranial vertebral artery occlusion who received emergency interventional recanalization in the First People's Hospital of Xianyang and XD group Hospital from September 2022 to January 2023 were collected,and the basic data of the patients were retrospectively analyzed,including preoperative symptoms,occlusion of blood vessels,recanalization grade,surgical complications,changes in clinical symptoms and signs at 24 hours,mRS score at 90 days,etc.Results The range of onset time in 6 cases was from 5 hours to 5 days.All responsible vessels were left vertebral arteries.The vertebral arteries were re-opened in all 6 patients,and the subjective symptoms such as dizziness/vertigo were significantly relieved in all patients 24 hours after the operation.One patient had thrombosis escape during the opening process,and had no symptoms after using intermediate catheter aspiration.mRS score at 90 days was good in all 6 patients.Conclusion Emergency intervention for Wallenberg syndrome caused by acute occlusion at the beginning of vertebral artery occlusion is safe and feasible,which can significantly alleviate patients'discomfort.

关 键 词：WALLENBERG综合征 椎动脉 急性缺血性卒中 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]