[1]吴 勇 黄书岚 徐海涛 朱晓楠 陶 祥 观龙彬 容嘉彬.阿司匹林在成人缺血型烟雾病血管重建术后的应用[J].中国临床神经外科杂志,2020,(07):421-423.[doi:10.13798/j.issn.1009-153X.2020.07.002]
 WU Yong,HUANG Shu-lan,XU Hai-tao,et al.Application of aspirin after revascularization in adult patients with ischemic moyamoya disease[J].,2020,(07):421-423.[doi:10.13798/j.issn.1009-153X.2020.07.002]
点击复制

阿司匹林在成人缺血型烟雾病血管重建术后的应用()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年07期
页码:
421-423
栏目:
论著
出版日期:
2020-07-25

文章信息/Info

Title:
Application of aspirin after revascularization in adult patients with ischemic moyamoya disease
文章编号:
1009-153X(2020)07-0421-03
作者:
吴 勇 黄书岚 徐海涛 朱晓楠 陶 祥 观龙彬 容嘉彬
430060 武汉,武汉大学人民医院神经外科(吴 勇、黄书岚、徐海涛、朱晓楠、陶 祥、观龙彬、容嘉彬)
Author(s):
WU Yong HUANG Shu-lan XU Hai-tao ZHU Xiao-nan TAO Xiang Guan Long-bin RONG Jia-bin.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
关键词:
缺血型烟雾病成人血管重建术阿司匹林疗效
Keywords:
Ischemic moyamoya disease Adult patients Aspirin Revascularization
分类号:
R 743.3; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2020.07.002
文献标志码:
A
摘要:
目的 探讨阿司匹林在成人缺血型烟雾病血管重建术后的应用效果。方法 回顾性分析2017年10月至2019年10月收治的符合入选标准的81例成人缺血型烟雾病的临床资料。47例术后应用阿司匹林(观察组),34例未使用阿司匹林(对照组)。结果 观察组吻合口通畅率(97.87%,46/47)与对照组(94.12%,32/34)无统计学差异(P>0.05)。术后3个月,观察组改良Rankin量表评分[(1.38±1.05)分]明显低于对照组[(1.88±1.01)分;P<0.05]。观察组术后短暂性脑缺血发作发生率(4.26%)、脑梗死发生率(6.38%)均明显低于对照组(分别为23.53%、26.47%;P<0.05)。两组颅内出血、硬膜下血肿发生率均无统计学差异(P>0.05)。结论 阿司匹林可减少成人缺血型烟雾病血管重建术后脑缺血事件,同时改善病人预后,并且不增加颅内出血风险
Abstract:
Objective To observe the clinical efficacy of aspirin after revascularization in adult patients with ischemic moyamoya disease. Methods The clinical data of 81 adult patients with ischemic moyamoya disease who underwent revascularization from October 2017 to October 2019 were analyzed retrospectively. The aspirin was used in 47 patients (observation group) and not in 34 patients (control group) after the operation. Results The incidence of transient ischemic attack (4.26%) and cerebral infarction (6.38%) in the observation group was significantly lower than those (23.53% and 26.47%, respectively) in the control group after the operation (P<0.05). The modified Rankin scale acore in the observation group (1.38±1.05) was significantly lower than that (1.88±1.01) in the control group after the operation (P<0.05). There was no significant sifference in postoperative anastomotic patency rate between both groups (P>0.05). Conclusion For adult patients with ischemic moyamoya disease undergoing revascularization, aspirin can reduce the probability of cerebral ischemic events after revascularization and improve the prognosis, and do not increase the risk of intracranial hemorrhage

参考文献/References:

[1] Kim JS. Moyamoya disease: epidemiology, clinical features, and diagnosis [J]. Stroke, 2016, 18(1): 2-11.
[2] 欧阳光,黄书岚,徐海涛,等. 脑血运重建治疗缺血性烟雾 病手术时机的选择[J]. 中国临床神经外科杂志,2019,16 (5):397-401.
[3] Arias EJ1, Derdeyn CP, Dacey RG Jr, et al. bAdvances and surgical considerations in the treatment of moyamoya disease [J]. Neurosurgery, 2014, 74(Suppl 1): S116-125.
[4] 李 伟,王增武,秦时强,等. 血管重建术治疗缺血型烟雾 病的疗效分析[J]. 中国临床神经外科杂志,2020,25(3): 161-162.
[5] Kraemer M, Berlit P, Diesner F, et al. What is the expert's option on antiplatelet therapy in moyamoya disease: results of a worldwide Survey [J]? Eur J Neurol, 2012, 19(1): 163- 167.
[6] 邱永逸,陈劲草,章剑剑,等. 成人烟雾病STA-MCA分流 术联合EMS后脑出血和高灌注综合征的关系[J].中国临 床神经外科杂志,2019,24(7):387-389.
[7] Scott RM, Smith ER. Moyamoya disease and moyamoya syn- drome [J]. N Engl J Med, 2009, 360(12): 1226-1237.
[8] Park W, Ahn JS, Lee HS, et al. Risk factors for newly deve- loped cerebral infarction after surgical revascularization for adults with moyamoya disease [J]. World Neurosurg, 2016, 92: 65-73.
[9] Muraoka S, Araki Y, Kondo G, et al. Postoperative cerebral infarction risk factors and postoperative management of pediatric patients with Moyamoya disease [J]. World Neuro- surg, 2018, 113: e190-e199.
[10] 郝继恒,刘卫东,张利勇,等. 颞浅动脉-大脑中动脉吻合 术治疗烟雾病的疗效分析[J]. 中华神经外科杂志,2014, 30(8):760-764.
[11] Yamada S, Oki K, Itoh Y, et al. Effects of surgery and anti- platelet therapy in ten-year follow-up from the registry study of research committee on Moyamoya disease in Japan [J]. J Stroke Cerebrovasc Dis, 2016, 25(2): 340-349.
[12] Klijn CJ, Kappelle LJ. Haemodynamic stroke: clinical features, prognosis, andmanagement [J]. Lancet Neurol, 2010, 9(10): 1008-1017.
[13] Jeon C, Yeon JY, Jo KI, et al. Clinical Role of Microembolic signals in adult moyamoya disease with ischemic stroke [J]. Stroke, 2019, 50(5): 1130-1135.
[14] Research committee on the pathology and treatment of spontaneous occlusion of the circle of willis; health labour sciences research grant for research on measures for infrac- table diseases guidelines for diagnosis and treatment of moyamoya disease (spontaneous occlusion of the circle of Willis) [J]. Neurol Med Chir (Tokyo), 2012, 52(5): 245-266.
[15] Onozuka D, Hagihara A, Nishimura K, et al. Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study) [J]. BMJ Open, 2016, 6(3): e1-e8 .
[16] Schubert GA, Biermann P, Weiss C, et al. Risk profile in extracranial/intracranial bypass surgery--the role of anti- platelet agents, disease pathology, and surgical technique in 168 direct revascularization procedures [J]. World Neurosurg, 2014, 82(5): 672-677.
[17] 哈斯也提·依不来音,马衣日木·赛买提,古孜丽努尔·吐 尼亚孜. 拜阿司匹林在EDAS术后预防脑梗死发生的作 用[J]. 医学综述,2015,21(15):2820-2822.
[18] Zhao Y, Zhang Q, Zhang D, et al. Effect of aspirin in post- operative management of adult ischemic moyamoya disease [J]. World Neurosurg, 2017, 105: 728-731.
[19] Fujimura M , Niizuma K, Inoue T, et al. Minocycline pre- vents focal neurological deterioration due to cerebral hyper- perfusion after extracranial-intracranial bypass for Moya-1 moya disease [J]. Neurosurgery, 2014, 74(2): 163-170.
[20] 李昌文,张 楠,夏成雨. 烟雾病脑血流重建术后常见并 发症及其处理的研究进展[J]. 中华神经医学杂志,2019, 18(10):1060-1064.

相似文献/References:

[1]高 俊,李智敏,王天宇,等.成人椎管内先天性肿瘤的手术治疗[J].中国临床神经外科杂志,2016,(11):670.[doi:10.13798/j.issn.1009-153X.2016.11.006]
 GAO Jun,LI Zhi-min,WANG Tian-yu,et al.Surgical treatment of intraspinal congenital neoplasms in adult patients[J].,2016,(07):670.[doi:10.13798/j.issn.1009-153X.2016.11.006]
[2]张绍辉,高 超,丁 平,等.成人症状性骶管囊肿的外科治疗[J].中国临床神经外科杂志,2016,(11):676.[doi:10.13798/j.issn.1009-153X.2016.11.008]
 ZHANG Shao-hui,SHANG Ai-jia,GAO Chao,et al.Surgical treatment of symptomatic sacral cyst in adults[J].,2016,(07):676.[doi:10.13798/j.issn.1009-153X.2016.11.008]
[3]胡重灵,娄四龙,陈锐,等.成人幕上原始神经外胚层肿瘤的诊治分析(附10例报道)[J].中国临床神经外科杂志,2017,(02):71.[doi:10.13798/j.issn.1009-153X.2017.02.003]
 HU Chong-ling,LOU Si-long,CHEN Rui,et al.Diagnosis and treatment of supratentorial primitive neuroectodermal tumor in adult patients (report of 10 cases)[J].,2017,(07):71.[doi:10.13798/j.issn.1009-153X.2017.02.003]
[4]张王成 综述 黄书岚 审校.成人难治性部分发作性癫痫的药物治疗研究进展[J].中国临床神经外科杂志,2017,(03):197.[doi:10.13798/j.issn.1009-153X.2017.03.028]
[5]李 舜 唐晓平 文 军 罗仁国 张 柳 段军伟 彭 华 赵 龙.成人出血型烟雾病合并颅内动脉瘤的诊治及预后分析[J].中国临床神经外科杂志,2017,(04):213.[doi:10.13798/j.issn.1009-153X.2017.04.002]
 LI Shun,TANG Xiao-ping,WEN Jun,et al.Diagnosis, treatment and prognosis of intracranial aneurysms in adults with hemorrhagic moyamoya disease[J].,2017,(07):213.[doi:10.13798/j.issn.1009-153X.2017.04.002]
[6]谭殿辉 许锦成 陈俊琛 吴 晋.成人孤立颅骨肌纤维瘤病1例[J].中国临床神经外科杂志,2018,(07):511.[doi:10.13798/j.issn.1009-153X.2018.07.023]
[7]赵志勇 尹 航 袁 帅 张景龙 张 赫 袁 治.成人颅骨朗格汉斯细胞组织细胞增生症囊变1例[J].中国临床神经外科杂志,2019,(11):716.[doi:10.13798/j.issn.1009-153X.2019.11.028]
[8]谢京城 陈晓东 杨 军.成人脊髓纵裂畸形导致的脊髓拴系综合征的治疗[J].中国临床神经外科杂志,2020,(06):344.[doi:10.13798/j.issn.1009-153X.2020.06.003]
 XIE Jing-cheng,CHEN Xiao-dong,YANG Jun..Surgical treatment for adult patients with tethered cord syndrome due to split cord malformation[J].,2020,(07):344.[doi:10.13798/j.issn.1009-153X.2020.06.003]
[9]肖宗宇 张正平 李坤正.成人颅后窝脑膜瘤术后并发小脑性缄默综合征1例[J].中国临床神经外科杂志,2020,(11):812.[doi:doi:10.13798/j.issn.1009-153X.2020.11.029]
[10]杨 帆 董 超 皇甫罗锴 张雷鸣 汤其华 程 岗 张剑宁.64例成人丘脑胶质瘤临床特点分析[J].中国临床神经外科杂志,2021,26(01):39.[doi:10.13798/j.issn.1009-153X.2021.01.013]

备注/Memo

备注/Memo:
(2020-02-11收稿,2020-04-01修回)通讯作者:黄书岚,E-mail:donghuyufu@qq.com
更新日期/Last Update: 2020-07-20