不同类型偏头痛合并卵圆孔未闭的患者行介入封堵术近中期疗效分析  

Clinical efficacy of interventional occlusion in patients with different types of migraine and patent foramen ovale

作　　者：黄嘉伟 王琼涛[2] 李鹏飞 HUANG Jiawei;WANG Qiongtao;LI Pengfei(Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Department of Cardiovascular Medicine,Xiaogan Central Hospital,Xiaogan,Hubei 432000,China)

机构地区：[1]锦州医科大学孝感市中心医院研究生培养基地,湖北孝感432000 [2]孝感市中心医院心血管内科,湖北孝感432000

出　　处：《中国医学工程》2023年第12期18-23,共6页China Medical Engineering

基　　金：湖北省孝感市自然科学研究计划项目(XGKJ2022010014)。

摘　　要：目的 分析不同类型的偏头痛患者行介入封堵术治疗的临床疗效,评估偏头痛合并卵圆孔未闭的患者行介入封堵术的安全性。方法 纳入2022年1月至2023年2月在孝感市中心医院就诊,以偏头痛为主要症状并确诊为卵圆孔未闭的患者共65例,其中先兆性偏头痛患者36例,无先兆性偏头痛患者17例,慢性偏头痛患者12例,术前详细收集一般资料,均行介入封堵术,于封堵术后1个月、3个月、6个月门诊复查超声心电图、心电图,记录头痛影响测评量表-6 (HIT-6)、视觉模拟评分法(VAS)、偏头痛残疾程度评估问卷(MIDAS),评估患者头痛缓解程度。结果 65例患者行介入封堵术均手术成功,无并发症。治疗后HIT-6评分、VAS评分、MIDAS评分均较术前明显下降(P<0.05)。比较三组患者术后6个月HIT-6评分、VAS评分、MIDAS评分之间差异,结果发现先兆性偏头痛组在VAS评分、MIDAS评分上明显低于慢性偏头痛(P<0.05),即先兆性偏头痛组头痛缓解程度最为明显,其次是无先兆性偏头痛,最后是慢性偏头痛。结论 卵圆孔未闭介入封堵术治疗偏头痛疗效可靠、安全性高、成功率高,先兆性偏头痛患者相较于其他类型偏头痛更能从中显著获益。【Objective】To analyze the clinical efficacy of interventional occlusion in patients with different types of migraine and evaluate the safety of interventional occlusion in patients with migraine and patent foramen ovale.【Methods】Sixty-five patients visited Xiaogan Central Hospital from January 2022 to February 2023 with migraine as the main symptom and confirmed patent foramen ovale were included.Among them,36 migraine with aura patients,17 migraine without aura patients and 12 chronic migraine patients were enrolled in this study.General data were collected in detail before operation.Interventional occlusion was performed in all patients.Echocardiography and electrocardiogram were reexamined at 1 month,3 months and 6 months after occlusion.Headache Impact Test-6(HIT-6),Visual Analogue Scale(VAS)and Migraine Disability Assessment(MIDAS)questionnaire were recorded to evaluate the degree of headache relief.【Results】Interventional occlusion was successfully performed in 65 patients without complications.After treatment,HIT-6 score,VAS score and MIDAS score were significantly lower than those before operation,with significant differences(P<0.05).The differences of HIT-6 score,VAS score and MIDAS score at 6 months after operation among the three groups were compared.The results showed that the VAS score and MIDAS score in the migraine with aura group were significantly lower than those in the chronic migraine group,and the differences were statistically significant(P<0.05),that is,the headache relief in the migraine with aura group was the most obvious,followed by migraine without aura,and finally chronic migraine.【Conclusion】Interventional occlusion of patent foramen ovale is effective,safe and has a high success rate in the treatment of migraine.Migraine with aura patients can benefit more significantly than other types of migraine.

关 键 词：卵圆孔未闭 偏头痛 介入封堵术 头痛影响测评量表-6评分 偏头痛残疾程度评估问卷评分 

分 类 号：R742[医药卫生—神经病学与精神病学]