合并新型冠状病毒肺炎、卵圆孔未闭的青年脑梗死急诊桥接治疗二例并文献复习  

Emergency Bridging Treatment of 2 Cases of Young Cerebral Infarction Complicated with Novel Coronavirus Pneumonia and Patent Foramen Ovale and Literature Review

作　　者：张洪阳 刘宁 徐建可 韩苗 刘雪梅 韩新生 ZHANG Hong-yang;LIU Ning;XU Jian-ke;HAN Miao;LIU Xue-mei;HAN Xin-sheng(Kaifeng Central Hospital,Henan Neurological Disease Regional Medical Center,Kaifeng 475000,Henan Province,China)

机构地区：[1]开封市中心医院/河南省神经疾病区域医疗中心,河南开封475000

出　　处：《罕少疾病杂志》2025年第2期6-8,共3页Journal of Rare and Uncommon Diseases

基　　金：开封市科技攻关计划项目(1903016);开封市软科学研究项目(2304070)。

摘　　要：目的在我院神经内科住院的两例合并有COVID-19和PFO的颅内大血管闭塞的青年脑梗死患者,行静脉溶栓桥接动脉取栓桥接治疗的病例,结合相关文献,分析其病因和发病机制。结果合并新型冠状病毒性肺炎的大血管闭塞的青年脑卒中患者,卵圆孔未闭是重要的病因。结论合并新冠肺炎的青年脑卒中患者急性期应尽早进行静脉溶栓、机械取栓等血管再通治疗,改善病人预后,病情稳定后要进一步完善包括TCD发泡试验、经食道超声或右心声学造影检查明确有无卵圆孔未闭因素导致的心源性卒中可能。新型冠状病毒感染在同时合并急性大血管闭塞的青年脑梗死病人中的病因、发病机制与卵圆孔未闭之间的关系,还需要更多病人的观察和研究进一步证实。Objective To report two cases of intracranial large vessel occlusive cerebral infarction complicated with COVID-19 and PFO who were treated by intravenous thrombolysis and arterial thrombolysis bridge.Methods Two cases of young cerebral infarction patients with intracranial large vessel occlusion complicated with COVID-19 and PFO admitted to the Department of Neurology of our hospital from December 2022 to March 2023,who were treated with intravenous thrombolytic bridging artery thrombolysis and bridging therapy,were analyzed in combination with relevant literature to analyze their etiology and pathogenesis.Results Patent foramen ovale was an important cause in young stroke patients with large blood vessel occlusion complicated with novel coronavirus pneumonia.Conclusion In the acute phase of young stroke patients complicated with COVID-19,venous thrombolysis and mechanical thrombolysis should be performed as soon as possible to improve the prognosis of patients.After the condition is stabilized,further improvement should be made including TCD foam test,transesophageal ultrasound or right echocardiography to determine whether there is a possibility of cardiac stroke caused by the factor of atresia ovalis.The relationship between the etiology,pathogenesis and patent foramen ovale infection of novel coronavirus in young cerebral infarction patients with acute large vascular occlusion needs to be further confirmed by more patient observation and research.

关 键 词：新型冠状病毒肺炎 卵圆孔未闭 脑梗死 桥接治疗 

分 类 号：R563.1[医药卫生—呼吸系统]