摘要
目的:探讨介入治疗对椎动脉颅外段闭塞引起的Wallenberg综合征（又称延髓背外侧综合征）的安全性和有效性。方法:收集2022年9月至2023年1月在咸阳市第一人民医院（4例）和西电集团医院（2例）急诊介入再通的6例椎动脉颅外段闭塞引起的Wallenberg综合征患者的临床资料，回顾性分析患者的基本资料、术前症状、闭塞血管、血管再通分级、手术并发症、24 h临床症状及体征变化、90 d 改良Rankin量表（mRS）评分等情况。结果:6例发病时间：最短5 h，最长5 d；责任血管均为左侧椎动脉（VA）；6例患者VA均获得开通，所有患者术后24 h头晕/眩晕等主观症状均明显减轻，1例在开通过程中发生血栓逃逸，采用中间导管抽吸后无症状。6例90 d mRS评分均预后良好。结论:对于VA闭塞起始处急性闭塞引起的Wallenberg综合征急诊介入开通治疗安全可行，可明显减轻患者主观症状。
Abstract
Objective:To explore the safety and efficacy of interventional therapy for the Wallenberg syndrome (dorsolateral medullary syndrome) caused by extracranial vertebral artery occlusion.Methods:The clinical data of 6 patients with Wallenberg syndrome caused by extracranial vertebral artery occlusion who received emergency interventional recanalization in the First People's Hospital of Xianyang and XD group Hospital from September 2022 to January 2023 were collected, and the basic data of the patients were retrospectively analyzed, including preoperative symptoms, occlusion of blood vessels, recanalization grade, surgical complications, changes in clinical symptoms and signs at 24 hours, mRS score at 90 days, etc.Results:The range of onset time in 6 cases was from 5 hours to 5 days. All responsible vessels were left vertebral arteries. The vertebral arteries were re-opened in all 6 patients, and the subjective symptoms such as dizziness/vertigo were significantly relieved in all patients 24 hours after the operation. One patient had thrombosis escape during the opening process, and had no symptoms after using intermediate catheter aspiration. mRS score at 90 days was good in all 6 patients.Conclusion:Emergency intervention for Wallenberg syndrome caused by acute occlusion at the beginning of vertebral artery occlusion is safe and feasible, which can significantly alleviate patients' discomfort.
基金项目
陕西省中医药管理局2021-202科研项目(2021-ZZ-LC033)
中国卒中学会脑血管病全程管理项目一启航基金(202001)
万方数据