中华医学杂志（英文版）2002，Vol.115Issue(3)：342-346,5.
大动脉炎所致的脑缺血的治疗
Management of cerebral ischemia due to Takayasu's arteritis
汪忠镐 1沈来根 2余军 3谷涌泉 1王世华 1管珩 1吴庆华 4张小明 5李鸣 6吴济东 2李国兴 1潘松林 1张鸿坤 2金炜2
作者信息
- 1. 北京邮电医院血管外科,北京,100032
- 2. 浙江大学医学院血管外科研究所,杭州,310003
- 3. 浙江大学医学院附属第一医院血管外科,杭州,310003
- 4. 北京协和医院外科,北京,100730
- 5. 北京安贞医院血管外科,北京,100029
- 6. 北京大学第三临床医学院血管外科,北京,100044
- 折叠
摘要
Abstract
Objective To explore the management of cerebral ischemia caused by Takayasu's arteritis. Methods Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one. Results Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%. Conclusion Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.关键词
大动脉炎/高安氏病/脑缺血/颈动脉/再灌注损伤Key words
aortoarteritis/Takayasu's arteritis/cerebral ischemia/carotid artery/reperfusion syndrome分类
医药卫生引用本文复制引用
汪忠镐,沈来根,余军,谷涌泉,王世华,管珩,吴庆华,张小明,李鸣,吴济东,李国兴,潘松林,张鸿坤,金炜..大动脉炎所致的脑缺血的治疗[J].中华医学杂志（英文版）,2002,115(3):342-346,5.
