标题：妊娠合并脑血管病24例诊治体会

      作者：罗鹏，钱东翔，王智坚，郭炜    (广州医科大学附属第三医院神经外科，广东 广州 510150)

      卷次： 2018年29卷10期

      【摘要】 目的 探讨妊娠合并脑血管病患者的临床诊治方法和效果。方法 回顾性分析广州医科大学附属第三医院2009年7月至2017年7月收治的24例妊娠合并脑血管病患者的临床资料、发病原因、治疗措施，总结诊疗体会。结果 24例患者中22例行头颅CT检查，16例接受DSA检查：阳性发现11例，其中颅内动脉瘤5例、动静脉畸形4例、颅内静脉窦血栓2例，合并脑出血1例；另有5例阴性发现。余8例患者未行DSA检查，1例直接开颅手术，术中确诊为颅内动静脉畸形出血合并脑肿瘤。所有患者中终止妊娠21例，2例拒绝终止妊娠，1例为产后两周起病；经手术、介入及多科协作等综合治疗，24例患者中19例痊愈出院，1例好转，1例转院，3例死亡。结论 妊娠合并脑血管病虽发病率低，但病因复杂、病情凶险，及时明确病因，早期处理原发病，可改善母婴预后。
      【关键词】 妊娠；脑血管病；治疗；预后
      【中图分类号】 R714.25 【文献标识码】 A 【文章编号】 1003—6350（2018）10—1460—03

Clinical experiences in cerebrovascular disease complications of pregnancy: a report of 24 cases.
LUO Peng, QIANDong-xiang, WANG Zhi-jian, GUO Wei. Department of Neurosurgery, the Third Affiliated Hospital of Guangzhou MedicalCollege, Guangzhou 510150, Guangdong, CHINA
【Abstract】 Objective To investigate the diagnosis and treatment of the pregnancy suffered with cerebrovascu-lar disease. Methods The clinical data of 24 cases of pregnancy combined with cerebrovascular disease, who admittedto the Third Affiliated Hospital of Guangzhou Medical College, were retrospectively analyzed, and the clinical experienc-es of these cases were summarized. Results There were 22 patients received skull computed tomography (CT) exami-nation and 16 patients received digital subtraction angiography (DSA) examination, of which11 cases were diagnosed aspositive by DSA, which included 5 cases of intracranial aneurysm, 4 cases of arteriovenous malformation (AVM), 2 cas-es of cerebral venous sinus thrombosis (CVST), 1 case of cerebral hemorrhage, and 5 cases were diagnosed for negative.The remaining 8 patients were not examined by DSA, one of them received open-skull operation immediately with the fi-nal diagnosis for brain hemorrhage caused by AVM combined with brain tumor. There were 21 patients experienced termi-nation of pregnancy, 2 patients refused termination of pregnancy and 1 patient suffered onset two weeks after the termina-tion of pregnancy. After the combined treatment of surgery, intervention, and multidisciplinary collaboration, among of 24cases, there were 19 case of fully recovering from illness, 1 case of improved better than before, 1 case of transferred to an-other hospital, and 3 cases of dead. Conclusion Although the incidence of these diseases is low, the high risk and thecomplicated etiopathogenesis results in high fatality. Understanding the etiopathogenesis of the disease in time, and heal-ing the primary disease early may play an important role in improving the prognosis of mother and infant.
      【Key words】 Pregnancy; Cerebrovascular disease; Treatment; Prognosis·临床经验·doi:10.3969/j.issn.1003-6350.2018.10.041