[1]李监松　骆　成　罗江兵　方　胜　李立峰　赵鹏洲.颅内动脉瘤夹闭术中载瘤动脉临时阻断后脑血流动力学变化：术中荧光造影定量分析[J].中国临床神经外科杂志,2021,26(06):410-413.[doi:10.13798/j.issn.1009-153X.2021.06.003]
　LI Jian-song,LUO Cheng,LUO Jiang-bing,et al.Cerebral hemodynamic changes after temporary occlusion of the parent artery during intracranial aneurysm clipping: quantitative analysis of introperative indocyanine green-video angiography[J].,2021,26(06):410-413.[doi:10.13798/j.issn.1009-153X.2021.06.003]
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颅内动脉瘤夹闭术中载瘤动脉临时阻断后脑血流动力学变化：术中荧光造影定量分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年06期
页码:
410-413
栏目:
论著
出版日期:
2021-06-25

文章信息/Info

Title:
Cerebral hemodynamic changes after temporary occlusion of the parent artery during intracranial aneurysm clipping: quantitative analysis of introperative indocyanine green-video angiography
文章编号:
1009-153X（2021）06-0410-04
作者:
李监松　骆　成　罗江兵　方　胜　李立峰　赵鹏洲
作者单位：529000 广东，江门市人民医院神经外科（李监松、罗江兵、方　胜、赵鹏洲），放射科（骆　成），院长办公室（李立峰）
Author(s):
LI Jian-song1;  LUO Cheng2;  LUO Jiang-bing1;  FANG Sheng1;  LI Li-feng3;  ZHAO Peng-zhou1.
1. Department of Neurosurgery, Jiangmen People’s Hospital, Jiangmen 529000, China; 2. Department of Radiology, Jiangmen People’s Hospital, Jiangmen 529000, China; 3. Hospital President’s Office, Jiangmen People’s Hospital, Jiangmen 529000, China
关键词:
颅内动脉瘤; 夹闭术; 载瘤动脉临时阻断; 血管荧光造影; 吲哚菁绿; 定量分析
Keywords:
Intracranial aneurysm;  Clipping;  Indocyanine green;  Fluorescein angiography;  Temporary parent artery occlusion;  Quantitative analysis
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2021.06.003
文献标志码:
A
摘要:
目的 探讨颅内动脉瘤夹闭术中载瘤动脉不同阻断方式对脑血流动力学的影响。方法 选取2018年1月至2020年12月夹闭术治疗的颅内动脉瘤23例和1例实验性动脉瘤，收集吲哚菁绿荧光造影资料，选择载瘤动脉近端、载瘤动脉远端、动脉瘤瘤囊、大脑皮层为感兴趣区域（ROI），软件分析荧光强度曲线，参数包括最大荧光强度（Imax）、脑血流指数（CBFi）、达峰时间（TTP）、上升时间（RT）。结果 载瘤动脉近端或远端阻断后，四个ROI的Imax、CBFi均明显降低（P<0.05）；近端阻断时载瘤动脉近、远端TTP、RT无明显变化（P>0.05），动脉瘤瘤囊、大脑皮层TTP、RT均明显增高（P<0.05）；远端阻断时，四个ROI的TTP、RT均明显增高（P<0.05）。载瘤动脉近、远端同时阻断后，载瘤动脉近远端、大脑皮层Imax、CBFi均明显降低（P<0.05），TTP、RT无明显变化（P>0.05），动脉瘤瘤囊Imax、CBFi、TTP、RT均接近0。结论 颅内动脉瘤夹闭术中，载瘤动脉近端临时阻断可引起动脉瘤瘤囊内Imax、CBFi明显下降，RT、TTP延长，可最大限度减少并发症，是一种相对安全、有效的临时阻断方式。
Abstract:
Objective To explore the effect of temporary occlusion of the parent artery (TO-PA) on the cerebral hemodynamics during intracranial aneurysm clipping. Methods Twenty-three patients with intracranial aneurysm and 1 with experimental aneurysm were recruited from January 2018 to December 2020. The fluorescence intensity curve was analyzed by software using introperative indocyanine green fluorescence angiography data. The proximal and distal segment of the parent artery, aneurysm sac, and cerebral cortex were selected as region of interest (ROI). The parameters included maximum fluorescence intensity (Imax), cerebral blood flow index (CBFi), time to peak (TTP), rise time (RT). Results After TO-PA on the proximal or distal segment of the parent artery, Imax and CBFi were significantly reduced in the four ROIs (P<0.05). After TO-PA on the proximal segment of the parent artery, TTP and RT were significantly increased in the aneurysm sac and cerebral cortex (P<0.05), but TTP and RT did not significantly changed in the proximal and distal segments of the parent artery (P>0.05). After TO-PA on the distal segment of the parent artery, TTP and RT were significantly increased in the four ROIs (P<0.05). After TO-PA on both the proximal and distal segmrnt of the parent artery, Imax and CBFi were significantly reduced (P<0.05) and TTP and RT did not significantly changed (P>0.05) in the proximal and distal segments of the parent artery and the cerebral cortex, while Imax, CBFi, TTP and RT were close to zero in the aneurysm sac. Conclusions during intracranial aneurysm clipping, TO-PA on the proximal segment of the parent artery can cause a significant decrease in Imax and CBFi and a prolongation of RT and TTP in the aneurysm sac, which can minimize the postoperative complications. It is a relatively safe and effective TO-PA method.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：广东省江门市科技计划项目（2018020200430003086）
更新日期/Last Update: 2021-06-25