急性缺血性中风引起的颈动脉外硬化病理

И. П. Дуданов, С. В. Ордынец, И. А. Лукинский, Б. С. Абуазаб, В. В. Ахметов, А. А. Шабонов, О. П. Вербицкий
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引用次数: 4

摘要

目的。本文介绍以头臂动脉非动脉粥样硬化性病变为病因的缺血性脑血管意外患者的治疗经验。材料和方法。2011-2015年共观察4118例急性缺血性脑卒中患者。其中589例(14.3%)在脑卒中急性期(4 ~ 6小时~ 14天)行手术。脑卒中的病因是头臂动脉颅外分支(EDBA)的各种病理。其中,动脉粥样硬化性颈动脉狭窄336例(57.1%)接受了手术,非动脉粥样硬化性颈动脉病变253例(42.9%)。253例患者中,颈动脉内膜剥离10例(3.9%),颈内动脉和颈内动脉颅外段动脉瘤14例(5.5%),229例(90.6%)颈动脉出现不同类型的扭曲、扭结和纤维发育不良。所有的病人都做了手术。各种颈动脉重建方法均取得了良好的临床效果。没有致命的结果。结论。本研究获得的数据证实,不仅ICA的动脉粥样硬化病变是早期手术治疗的指征。这一阶段是急性缺血性脑卒中患者综合康复的重要环节。
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ЭКСТРАКРАНИАЛЬНАЯ НЕАТЕРОСКЛЕРОТИЧЕСКАЯ ПАТОЛОГИЯ СОННОЙ АРТЕРИИ В ПРИЧИНАХ РАЗВИТИЯ ОСТРОГО ИШЕМИЧЕСКОГО ИНСУЛЬТА
Purpose. We present the experience of treatment of patients with cerebral vascular accident by the ischemic type, the cause of which was non-atherosclerotic lesion of brachiocephalic arteries. Materials and methods. During 2011–2015 years 4118 patients with acute ischemic stroke were observed. Of these, 589 patients (14.3%) were operated in the acute period of stroke in the period from 4–6 hours to 14 days. The cause of the stroke was various types of pathology of the extracranial divisions of the brachiocephalic arteries (EDBA). Of this number, with atherosclerotic carotid artery stenoses, 336 patients (57.1%) were operated on, with non-atherosclerotic pathology of carotid arteries — 253 patients (42.9%). Of these 253 patients, dissection of the intima of the carotid arteries was detected in 10 (3.9%) patients, aneurysms in the extracranial segment of the ECA and ICA were detected in 14 (5.5%), and 229 (90.6%) revealed various types of tortuosity and kinks carotid arteries and fibrous dysplasia. All patients are operated on. Various types of reconstructions of carotid arteries with a good clinical effect have been performed. There were no lethal outcomes. Concusions. The data obtained in the study confirm the opinion that not only atherosclerotic lesions of the ICA are an indication for surgical treatment at an early date. This stage is an important part of the comprehensive rehabilitation of patients with acute ischemic stroke.
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