尼日利亚脑动脉瘤剪切的结果:一个单一中心的经验
Jeuel O Idowu1, Olufemi Idowu2,3, Stephen O Oyeleke3
1Finnih Medical Centre, Ikeja, Lagos, Nigeria.
概括
破裂的大脑动脉动脉瘤 (RCAA) 是严重的. 在尼日利亚,手术的机会有限,切割是主要的治疗方法. 这项研究回顾了RCAA患者9年的剪切结果.
科学领域:
- 神经外科 神经外科
- 血管神经学 血管神经学
- 公共卫生 公共卫生
背景情况:
- 破裂的大脑动脉动脉瘤 (RCAA) 呈现出显著的发病率和死亡率.
- 在尼日利亚,获得神经外科服务和先进的治疗方法,如动脉瘤卷曲,是有限的.
- 这项研究侧重于9年间脑动脉瘤剪切的临床结果.
研究的目的:
- 评估尼日利亚脑动脉瘤切割的临床结果.
- 分析影响RCAA患者治疗剪切治疗结果的因素.
- 突出尼日利亚RCAA获得神经外科护理的挑战.
主要方法:
- 在2012年3月至2021年6月期间接受治疗的29名RCAA患者的回顾性分析.
- 收集的数据包括人口统计,世界神经外科协会联合会 (WFNS) 等级,亨特和赫斯 (HH) 等级,动脉瘤位置和手术时间.
- 用格拉斯哥结局尺度 (GOS) 评估患者的结果.
主要成果:
- 最受影响的年龄组是50-59岁,动脉瘤通常发生在中脑动脉和后沟通动脉 (PComA) 区域.
- 大多数患者在24小时后出现,65.5%的患者在手术前经历了再出血. 在27.6%的病例中,早期切割 (<72小时) 是可能的.
- 总体死亡率为17.2%. 手术前的WFNS和HH等级与GOS分数有显著的相关性. 没有PComA动脉瘤患者死亡.
结论:
- 迟到的呈现和有限的神经外科护理,受到诸如低诊断和财务挑战等因素的影响,导致RCAA的结果不佳.
- 动脉瘤剪切在资源有限的环境中仍然是一个关键的干预措施,在这些环境中,卷轴是不可用的.
- 需要进一步的研究和改善医疗保健基础设施,以应对尼日利亚管理RCAA的挑战.
相关概念视频
Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...


