摘要
目的:探讨颈动脉颅外段与颅内动脉狭窄血管内成型术疗效。方法:选取2009年1月～2011年1月收入的患者共36例,其中颅内血管狭窄患者15例,颅外血管狭窄患者21例,给予手术治疗,患者术后随访3年,行数字减影血管造影(TCD)及经颅多普勒超声(DSA)评价、ASPECTS量表评分,并对患者术后并发症进行评估。结果:本组36例患者全部放置成功,患者术后各项参考均显著改善,轻度狭窄的TCD与DSA相符率为56%,中度与重度的相符率分别为75%与78%。患者术后1月、1年、3年的峰值流速、舒张末期流速、平均流速较术前减慢,而脉动指数较术前增高,差异均有统计学意义(P<0.05)。两组患者术后1月及术后3年的ASPECTS评分与术前对比差异有统计学意义(P<0.05)。两组患者行支架治疗后,颅内支架组患者成功14例,失败1例,成功率93.3%。术后脑出血2例,血管痉挛1例,再闭塞2例,心率、血压下降1例。颅外支架组成功20例,失败1例,成功率95.2%。再闭塞1例,心率、血压下降5例。结论:血管内支架成形术可以很好的治疗症状性脑动脉狭窄,但技术要求较高,尤其是颅内血管支架成形术。和颅外血管支架成形术相比,颅内血管支架成形术术后并发症相对较多。
Objective：To investigate the carotid artery of extracranial and intracranial artery stenosis angioplasty efficacy.Methods：36 cases Patients were selected from January 2009 to January 2011,15 cases were intracranial vascular stenosis,21 cases were extracranial artery stenosis,they were all given the surgery,patients were followed up for 3 years,by TCD,and DSA in evaluationASPECTS scale score,and postoperative complications were evaluated.Results：All 36 patients were placed successfully,The parameters of the patients after surgery were significantly improved,consistent with mild stenosis TCD and DSA rate of 56%,moderate and severe match rate of 75% and 78%,respectively.Patients in January,1 year,3-year peak flow velocity,diastolic velocity,mean flow velocity compared with the preoperative slow down,and pulsatility index is higher than before surgery,the differences were statistically significant（P〈0.05）.There was significant difference in ASPECTS score between preoperative and 1 month or 3 years after surgery（P〈0.05）.The two groups of patients with stents in patients with intracranial stent group successful in 14 cases,failure of one cases,the success rate of 93.3%.2 cases of postoperative intracerebral hemorrhage,vasospasm,and 2 cases of re-occlusion,heart rate,blood pressure decreased by 1.Extracranial stent group was successful in 20 cases,failure in 1 case,the success rate of 95.2%.The reocclusion 1 cases,heart rate,blood pressure,a decrease of 5 cases.Conclusion：Endovascular stenting surgery can be a good treatment of symptomatic cerebral artery stenosis,but the higher technical requirements,especially intracranial vascular stenting.And extracranial vascular stent angioplasty compared with intracranial vascular stent placement postoperative complications was relatively high.
出处
《中国医药导刊》
2012年第6期963-964,966,共3页
Chinese Journal of Medicinal Guide
基金
河北省自然科学基金(编号:C2010000915)
关键词
血管内成型术
脑卒中
颅内动脉狭窄
Vascular angioplasty
Stroke
Intracranial arterial stenosis
