摘要
目的探讨烟雾病患者搭桥术后发生脑梗死的相关影响因素及预防措施。方法回顾性分析2018年1月至2022年12月我院收治的102例烟雾病患者临床资料,均开展搭桥术治疗,术后依据患者是否发生脑梗死分为发生组与未发生组,收集两组年龄(≥39岁,<39岁)、性别(男,女)、BMI(>23.9kg/m2,≤23.9kg/m2)、吸烟史(有,无)、饮酒史(有,无)、糖尿病史(有,无)、高血压病史(有,无)、高血脂病史(有,无)、手术方式(直接搭桥术,联合搭桥术)、搭桥侧别(左侧,右侧)、术前舒张压(≥80mmHg,<80mmHg)、术前收缩压(≥140mmHg,<140mmHg)、尼莫地平预防使用情况(使用,未使用)、Suzuki分期(≥4期,<4期)等多方面基础资料,先行单因素分析,再行Logistic回归分析,获得影响烟雾病搭桥术后发生脑梗死的独立危险因素。结果102例烟雾病患者术后15例发生脑梗死,发生率为14.71%(15/102);两组糖尿病史、高血压病史、术前收缩压、尼莫地平预防使用情况、Suzuki分期相比,差异有统计学意义(P<0.05);多因素显示,有糖尿病史、有高血压病史、术前收缩压≥140mmHg、未预防性使用尼莫地平、Suzuki分期≥4期为影响烟雾病搭桥术后发生脑梗死的高危因素(P<0.05且OR>1)。结论烟雾病患者搭桥术后脑梗死风险偏高,与有糖尿病史、有高血压病史、术前收缩压≥140mmHg、未预防性使用尼莫地平、Suzuki分期≥4期关系密切,还需完善早期预防措施,降低脑梗死风险。
Objective To explore the relevant influencing factors and preventive measures of cerebral infarction in patients with moyamoya disease after bypass surgery.Methods The clinical data of 102 patients with moyamoya disease admitted to our hospital from January 2018 to December 2022 were retrospectively analyzed.All patients were treated with bypass surgery.After surgery,patients were divided into incidence group and non incidence group according to whether they had cerebral infarction.The age(≥39years old,<39years old),gender(male,female),BMI(>23.9kg/m2,≤23.9 kg/m2),smoking history(yes,no),drinking history(yes,no),diabetes history(yes,no),a history of hypertension(yes,no),a history of hyperlipidemia(yes,no),surgical methods(direct bypass surgery,combined bypass surgery),bypass side(left,right),preoperative diastolic blood pressure(≥80mmHg,<80mmHg),preoperative systolic blood pressure(≥140mmHg,<140mmHg),prophylactic use of nimodipine(used,not used),Suzuki staging(≥4,<4),and other basic data were analyzed using univariate analysis,Further logistic regression analysis was conducted to identify independent risk factors for cerebral infarction after Moyamoya disease bypass surgery.Results Among the 102 patients with Moyamoya disease,15 developed cerebral infarction after surgery,with an incidence rate of 14.71%(15/102).There were significant differences between the two groups in diabetes history,hypertension history,preoperative systolic blood pressure,nimodipine prevention use,Suzuki stage(P<0.05);multivariate analysis showed that the history of diabetes,hypertension,preoperative systolic blood pressure≥140 mmHg,non prophylactic use of nimodipine,and Suzuki stage≥4 were high risk factors for cerebral infarction after bypass surgery in moyamoya disease(P<0.05 and OR>1).Conclusion The risk of cerebral infarction in patients with moyamoya disease after bypass surgery is relatively high,which is closely related to the history of diabetes,hypertension,preoperative systolic blood pressure≥140mmHg,non preventive use of nimodipine,and Suzuki stage≥4.Early prevention measures need to be improved to reduce the risk of cerebral infarction.
作者
高珊
GAO Shan(The Second Ward of Neurosurgery,Zhoukou Central Hospital,Zhoukou 466000,Henan Province,China)
出处
《罕少疾病杂志》
2024年第12期1-3,共3页
Journal of Rare and Uncommon Diseases
关键词
烟雾病
搭桥术
脑梗死
影响因素
预防措施
Moyamoya Disease
Bridging Surgery
Cerebral Infarction
Influencing Factors
Preventive Mmeasure
