抗癲癇藥物對頸內動脈內膜剝脫術后腦高灌注綜合征的防治體會_West China Medical Journal

Authors：

 馮大磊 ^1,2 , 葉明 ¹ , 焦力群 ¹

1. ;
2. ;

Corresponding?author：

Keywords：

頸內動脈內膜剝脫術; 圍手術期; 腦高灌注綜合征; 抗癲癇藥物

DOI：

10.7507/1002-0179.201600473

Video：

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目的探討頸內動脈內膜剝脫術（CEA）圍手術期應用抗癲癇藥物對防治CEA后腦高灌注綜合征（CHS）的效果。方法選擇2012年4月-10月有CHS危險因素的CEA患者75例，隨機分為治療組（37例）和對照組（38例）。對照組患者應用抗血小板藥物、他汀類藥物治療，治療組患者在對照組的基礎上，于術前3 d開始口服丙戊酸鈉緩釋片，觀察其術后1周、3個月的臨床表現。結果治療組患者術后1周出現CHS相關表現11例（29.7%），無癲癇發作（0.0%）；術后3個月CHS相關表現全部消失，仍無癲癇發作。對照組患者術后1周出現CHS相關表現23例（60.5%），癲癇發作3例（7.9%）；術后3個月后13例（35.1%）仍有輕度CHS相關表現，無癲癇發作。兩組比較差異有統計學意義（P < 0.05）。結論圍手術期應用抗癲癇藥物可有效降低CEA后出現CHS相關表現和癲癇發作概率。

Citation： 馮大磊, 葉明, 焦力群. 抗癲癇藥物對頸內動脈內膜剝脫術后腦高灌注綜合征的防治體會. West China Medical Journal, 2016, 31(10): 1720-1722. doi: 10.7507/1002-0179.201600473 Copy

1.	Wilkinson JT, Adams HP, Wright CB. Convulsions after carotid endarterectomy[J]. JAMA, 1980, 244(16): 1827-1828.
2.	Wagner WH, Cossman D, FarberA, et al. Hyperperfusion syndrome after carotid endarterectomy[J]. Ann Vasc Surg, 2005, 19(4): 479-486.
3.	Barnett HJ, Elisziw M, Meldrum HE. Evidence based cardiology: prevention of ischaemic stroke[J].BMJ, 1999, 318(7197): 1539-1543.
4.	Stmdt TM, Sharbrough FW, Piepgras DG, et al. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia[J]. Mayo Clin Proc, 1981, 56(9): 533-543.
5.	李萌, 鄭宇, 張鴻祺, 等.頸動脈內膜切除術后高灌注綜合征的診斷與治療[J].中國腦血管病雜志, 2005, 2(8): 348-351.
6.	Meyers PM, Higashida RT, Phatouros CC, et al. Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries[J]. Neurosurgery, 2000, 47(2): 335-343.
7.	Ramírez-Moreno JM, Constantino-Silva AB, Gómez-Baquero MJ, et al. Cerebral hyperperfusion syndrome following a carotid endartereetomy[J]. Rev Neurol, 2010, 51(11): 699-701．.
8.	樊新穎, 徐格林, 劉新峰.腦過度灌注綜合征的監測[J].中華神經醫學雜志, 2006, 5(9): 968-970.
9.	周定標.頸動脈內膜切除[M].北京:人民軍醫出版社, 2005: 56-58.
10.	Ivens S, Kaufer D, Flores LP, et al. TGF-beta receptor-mediated albumin uptake into astrocytes is involved in neocortical epileptogenesis[J]. Brain, 2007, 130(Pt 2): 535-547.
11.	劉偉, 張茁.腦高灌注綜合征[J].中華老年心腦血管病雜志, 2012, 14(1): 56-58.

1. Wilkinson JT, Adams HP, Wright CB. Convulsions after carotid endarterectomy[J]. JAMA, 1980, 244(16): 1827-1828.
2. Wagner WH, Cossman D, FarberA, et al. Hyperperfusion syndrome after carotid endarterectomy[J]. Ann Vasc Surg, 2005, 19(4): 479-486.
3. Barnett HJ, Elisziw M, Meldrum HE. Evidence based cardiology: prevention of ischaemic stroke[J].BMJ, 1999, 318(7197): 1539-1543.
4. Stmdt TM, Sharbrough FW, Piepgras DG, et al. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia[J]. Mayo Clin Proc, 1981, 56(9): 533-543.
5. 李萌, 鄭宇, 張鴻祺, 等.頸動脈內膜切除術后高灌注綜合征的診斷與治療[J].中國腦血管病雜志, 2005, 2(8): 348-351.
6. Meyers PM, Higashida RT, Phatouros CC, et al. Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries[J]. Neurosurgery, 2000, 47(2): 335-343.
7. Ramírez-Moreno JM, Constantino-Silva AB, Gómez-Baquero MJ, et al. Cerebral hyperperfusion syndrome following a carotid endartereetomy[J]. Rev Neurol, 2010, 51(11): 699-701．.
8. 樊新穎, 徐格林, 劉新峰.腦過度灌注綜合征的監測[J].中華神經醫學雜志, 2006, 5(9): 968-970.
9. 周定標.頸動脈內膜切除[M].北京:人民軍醫出版社, 2005: 56-58.
10. Ivens S, Kaufer D, Flores LP, et al. TGF-beta receptor-mediated albumin uptake into astrocytes is involved in neocortical epileptogenesis[J]. Brain, 2007, 130(Pt 2): 535-547.
11. 劉偉, 張茁.腦高灌注綜合征[J].中華老年心腦血管病雜志, 2012, 14(1): 56-58.

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West China Medical Journal

抗癲癇藥物對頸內動脈內膜剝脫術后腦高灌注綜合征的防治體會

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