摘要
目的探讨头颈部血管狭窄支架置入术对缺血性脑血管病防治的有效性及安全性。方法选择符合本研究设计的2008年8月～2012年3月在西安交通大学第二附属医院神经内科住院、接受全脑血管造影术且行血管内支架置入术的122例患者作为研究对象。观察:(1)靶病变血管病变的分布情况、支架置入成功率;(2)脑梗死患者术前及术后1个月临床神经功能缺失评分(NIHSS),术后3个月时改良Rankin评分(mRS);(3)随访期间用药依从性、脑血管病复发率及其他并发症的发生情况。结果 (1)不同年龄段靶病变血管的分布不同,青年组以颅内血管病变为主,中老年组以颅外血管病变为主;支架置入手术成功率为92.62%;围手术期严重并发症发生9例(7.38%),其中死亡5例(4.10%)。(2)76例围手术期后生存的脑梗死患者,术前及术后1个月NIHSS有统计学差异(P<0.01);术后3个月mRS≤2分者63例(82.89%)。(3)终末随访时正规服药者73例(65.77%);随访期间发生缺血性脑血管病17例(13.93%),共发生支架再狭窄10例(8.20%);总死亡及植物状态10例(8.20%),支架手术相关性死亡及植物状态6例(4.92%)。结论支架置入术对缺血性脑血管病的近期和远期治疗安全有效。定期门诊检查,可以提高患者术后用药的依从性。
Objective To explore the efficacy and safety of the stent placement for head and neck vascular stenosis for the prevention and treatment to ischemic cerebrovaseular disease. Methods We assessed 122 patients with ischemic ce- rebrovascular disease who were admitted to Department of Neurology, the Second Affiliated Hospital of Xi＇an Jiaotong Uni- versity from August 2008 to March 2012. All patients underwent the cerebral angiography and the intravascular stenting. First,we observed the distribution of target lesion and success rate of stent implantation. Second,we proceed NIHSS evalua- tion to all patients preoperatively and 1 month postoperatively, as well as modified Rankin evaluation at 3 month postopera- tively. In addition, all patients were observed the medication compliance, the recurrence rate of cerebrovascular disease and other complications. Results （ 1 ） Different distribution of the target lesion at different ages. Intracranial vascular lesions wereas main in the youth group, and extracranial vascular disease was main in middle and -aged groups. The success rate of stent implantation was 92.62%. We found that 9 patients （7.38%） developed severe complications between within periop- eration and 5 patients were dead （4.10%）. （2）At 1 months postoperatively, the NIHSS scores in 76 patients who survived with cerebral infarction wereas significantly different （P 〈 0.01 ） compared with preoperative scores. 63 patients （82.89%） attained mRS scores ≤2 after 90 days. （3） The number of cases who were prescribed medication was 73 （65.77%） , 17 ca- ses occurred ischemic cerebrovascular disease （ 13.93% ） and 10 cases had stent restenosis （8.20%）, 10 patients （8. 20% ） developed death and vegetative state,6 patients＇ death was related to stent implantation. Conclusion Stenting is safe and effective on short-term and long-term treatment of ischemic cerebrovascular disease. Regular outpatient visit can im- prove the medication compliance of patients.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2013年第2期157-160,共4页
Journal of Apoplexy and Nervous Diseases
关键词
缺血性脑血管病
支架置入术
随访
Ischemic cerebrovascular disease
Stenting
Follow-up
