拜阿司匹林在EDAS术后预防脑梗死发生的作用

摘要

Objective To investigate the effect of bayaspirin in prevention of cerebral infarction after encephalo-duro-arterio-synangiosis ( EDAS ) .Methods Patients diagnosed as moyamoya and treated by EDAS in the domestic 3A hospitals(the Second Affiliated Hospital of Xinjiang Medical University,the First Affiliated Hospital of Xinjiang Medical University,the People′s Hospital of Xinjiang Autonomous Region,the People′s Hospital of Shandong Weifang,the Central Hospital of Shandong Liaocheng,the Affiliated Hospital of Qingdao Medical University,the People′s Hospital of Rizhao) from Sep.2012 to May 2014 were collected. The patients were divided into two groups according to whether bayaspirin was used to prevent cerebral infarction.After 3,7,30,90 days cerebral MRI was done to observe the infarction occurrence.Cases with complete MRI results of 3,7,10,30,90 days after operation were collected to review the role of bayaspirin in the prevention of cerebral infarction after EDAS .Results In the aspirin group,there were 4 cases of postop-erative cerebral hemorrhage(5.1%),6 cases of cerebral infarction(7.7%);in the non-aspirin group,there was 1 case of cerebral hemorrhage (1.0%),19 cases of cerebral infarction(19.6%).The incidence of cere-bral infarction of the aspirin group was significantly lower than the non-aspirin group(P<0.05),while there was no significant difference in the cerebral hemorrhage between the two groups ( P>0.05 ) .Conclusion Bayaspirin can effectively reduce the risk of cerebral infarction after EDAS ,especially for the posterior circu-lation blood supply region,but it also increases the risk of cerebral hemorrhage to some extent.%目的：探讨拜阿司匹林在硬脑脑膜颞浅动脉血管融通术（ EDAS）术后预防脑梗死发生的作用。方法收集2012年9月至2014年5月在国内多家三级甲等医院（新疆医科大学第二附属医院、新疆医科大学第一附属医院、新疆维吾尔自治区人民医院，潍坊市人民医院、聊城市中心医院、青岛医科大学附属医院、日照人民医院）收住的明确诊断为烟雾病，并接受 EDAS术的患者。根据术后是否应用拜阿司匹林预防脑梗死，将患者分为阿司匹林组（78例）和非阿司匹林组（97例）。术后3、7、30、90 d例行复查头颅磁共振成像观察脑梗死发生情况。收集具有完整术后3、7、30、90 d 磁共振成像复查结果的病例统计脑梗死发生情况，回顾性研究拜阿司匹林在 EDAS 术后预防脑梗死的作用。结果阿司匹林组术后脑出血4例（5．1％），脑梗死6例（7．7％）；非阿司匹林组脑出血1例（1．0％），脑梗死19例（19．6％）。阿司匹林组脑梗死的发生率显著低于非阿司匹林组（P＜0．05），两组脑出血发生率差异无统计学意义（ P＞0．05）。结论拜阿司匹林在EDAS术后能有效地降低脑梗死发生的风险，尤其是后循环供血区明显，但一定程度上也加重了脑出血发生的风险。