目的探讨颞浅动脉-大脑中动脉端侧吻合术中不同临时阻断技术的效果及可靠性。方法回顾性分析2015年1月—2023年4月南方医科大学南方医院神经外科收治的接受直接搭桥术治疗的烟雾病患者资料,根据临时阻断策略的不同将患者分为3组:①有垫...目的探讨颞浅动脉-大脑中动脉端侧吻合术中不同临时阻断技术的效果及可靠性。方法回顾性分析2015年1月—2023年4月南方医科大学南方医院神经外科收治的接受直接搭桥术治疗的烟雾病患者资料,根据临时阻断策略的不同将患者分为3组:①有垫片、多阻断夹阻断组(multi-clips+rubber pad group,M+R组);②无垫片、多阻断夹阻断组(multi-clips group,M组);③无垫片、单阻断夹阻断组(single-clip group,S组)。比较组间临时阻断时间、受体动脉切开后有无渗血、术中穿支血管损伤以及术后新发脑梗死情况。结果共355例患者、360个大脑半球纳入分析,按大脑半球统计患者360例,其中男性188例,女性172例,平均年龄为(43.8±0.7)岁。其中M+R组45例,M组191例,S组124例。3组平均阻断时间:M+R组为(37.9±9.8)min,M组为(20.9±9.0)min,S组为(11.0±3.5)min,组间差异有统计学意义(P<0.001)。阻断后受体动脉管腔内渗血以及术中穿支血管损伤发生率:M+R组为8.89%(阻断后受体动脉渗血4例),M组为14.66%(阻断后受体动脉渗血19例,术中穿支血管损伤8例,临时阻断部位有血栓形成1例),S组为5.65%(阻断后受体动脉渗血7例),组间差异无统计学意义(P>0.05)。术后新发脑梗死发生率差异无统计学意义(P>0.05)。结论单阻断夹阻断策略安全、有效,能显著缩短临时阻断时间,可以优先考虑作为颞浅动脉-大脑中动脉端侧吻合过程中的临时阻断策略。展开更多
The Aiketik Group, distributed at the western end of the South TianshanMountains, China, is an important lithostratigraphic unit involved in the South Tianshan orogen. Itis separated from the adjacent rocks by faults....The Aiketik Group, distributed at the western end of the South TianshanMountains, China, is an important lithostratigraphic unit involved in the South Tianshan orogen. Itis separated from the adjacent rocks by faults. Generally, the geologists ascribed it to the UpperCarboniferous according to Pseudostaffella sp., Profusulinella sp. and Fusulinella sp. found fromthe limestone and sandy limestone of Aiketik. Our radiolarian fossils were obtained from the chertsamples collected from the Haladaok section located at the upper Tuoshihan River. The fossils mainlyinclude Albaillella undulata Deflandre, Albaillella paradoxa Deflandre, Albaillella sp. aff. A.paradoxa Deflandre, Albaillella sp. cf. A. deflandrei Gourmelon, Albaillella sp., Albaillellaexcelsa Ishiga, Kito and Imoto (?), Belowea variabilis (Ormiston et Lane), Callella cf. C.parvispinosa Won, Entactinia cf. E. tortispina Ormiston et Lane, Entactinia aff. E. tortispinaOrmiston et Lane, Entactinia variospina Won, Entactinia sp., Eostylodictya rota (Won),Latentifistula impella (Ormistone et Lane) (?), Latentifistula turgita Omiston et Lane,Latentifistulidae gen. et. sp. indet. and Polyentactinia cf. aranea Gourmelon. Among them,Albaillella excelsa Ishiga, Kito and Imoto (?) is a Late Permian species with some elementsuncertain as there is only one poorly-preserved fossil of this species found so far. And tworadiolarian assemblages can be identified from the other fossils. One is the early EarlyCarboniferous assemblage represented by Albaillella undulata Deflandre, Albaillella paradoxa andAlbaillella sp. cf. A. deflandrei Gourmelon. And the other is the late Early Carboniferousassemblage represented by Eostylodictya rota (Won). This is the first discovery of radiolarianfossils in the Aiketik Group, also the first discovery of Late Permian radiolarian fossils in theSouth Tianshan Mountains. Meanwhile, this is the current westernmost sampling site of radiolarianfossils in the South Tianshan Mountains.展开更多
文摘目的探讨颞浅动脉-大脑中动脉端侧吻合术中不同临时阻断技术的效果及可靠性。方法回顾性分析2015年1月—2023年4月南方医科大学南方医院神经外科收治的接受直接搭桥术治疗的烟雾病患者资料,根据临时阻断策略的不同将患者分为3组:①有垫片、多阻断夹阻断组(multi-clips+rubber pad group,M+R组);②无垫片、多阻断夹阻断组(multi-clips group,M组);③无垫片、单阻断夹阻断组(single-clip group,S组)。比较组间临时阻断时间、受体动脉切开后有无渗血、术中穿支血管损伤以及术后新发脑梗死情况。结果共355例患者、360个大脑半球纳入分析,按大脑半球统计患者360例,其中男性188例,女性172例,平均年龄为(43.8±0.7)岁。其中M+R组45例,M组191例,S组124例。3组平均阻断时间:M+R组为(37.9±9.8)min,M组为(20.9±9.0)min,S组为(11.0±3.5)min,组间差异有统计学意义(P<0.001)。阻断后受体动脉管腔内渗血以及术中穿支血管损伤发生率:M+R组为8.89%(阻断后受体动脉渗血4例),M组为14.66%(阻断后受体动脉渗血19例,术中穿支血管损伤8例,临时阻断部位有血栓形成1例),S组为5.65%(阻断后受体动脉渗血7例),组间差异无统计学意义(P>0.05)。术后新发脑梗死发生率差异无统计学意义(P>0.05)。结论单阻断夹阻断策略安全、有效,能显著缩短临时阻断时间,可以优先考虑作为颞浅动脉-大脑中动脉端侧吻合过程中的临时阻断策略。
基金the Chinese Nationa1Natural Science Foun dation (Grant 40072077) the Tarim Oil Field Company,Petro China(Grant2098050230).
文摘The Aiketik Group, distributed at the western end of the South TianshanMountains, China, is an important lithostratigraphic unit involved in the South Tianshan orogen. Itis separated from the adjacent rocks by faults. Generally, the geologists ascribed it to the UpperCarboniferous according to Pseudostaffella sp., Profusulinella sp. and Fusulinella sp. found fromthe limestone and sandy limestone of Aiketik. Our radiolarian fossils were obtained from the chertsamples collected from the Haladaok section located at the upper Tuoshihan River. The fossils mainlyinclude Albaillella undulata Deflandre, Albaillella paradoxa Deflandre, Albaillella sp. aff. A.paradoxa Deflandre, Albaillella sp. cf. A. deflandrei Gourmelon, Albaillella sp., Albaillellaexcelsa Ishiga, Kito and Imoto (?), Belowea variabilis (Ormiston et Lane), Callella cf. C.parvispinosa Won, Entactinia cf. E. tortispina Ormiston et Lane, Entactinia aff. E. tortispinaOrmiston et Lane, Entactinia variospina Won, Entactinia sp., Eostylodictya rota (Won),Latentifistula impella (Ormistone et Lane) (?), Latentifistula turgita Omiston et Lane,Latentifistulidae gen. et. sp. indet. and Polyentactinia cf. aranea Gourmelon. Among them,Albaillella excelsa Ishiga, Kito and Imoto (?) is a Late Permian species with some elementsuncertain as there is only one poorly-preserved fossil of this species found so far. And tworadiolarian assemblages can be identified from the other fossils. One is the early EarlyCarboniferous assemblage represented by Albaillella undulata Deflandre, Albaillella paradoxa andAlbaillella sp. cf. A. deflandrei Gourmelon. And the other is the late Early Carboniferousassemblage represented by Eostylodictya rota (Won). This is the first discovery of radiolarianfossils in the Aiketik Group, also the first discovery of Late Permian radiolarian fossils in theSouth Tianshan Mountains. Meanwhile, this is the current westernmost sampling site of radiolarianfossils in the South Tianshan Mountains.
