摘要
目的 探讨颈动脉支架置入术（carotid artery stenting,CAS）的围手术期低血流动力学发生率及其相关危险因素.方法 收集我院2008年～2011年间接受血管内支架成形术的症状性颈动脉狭窄患者42例,分析围手术期（30 d内）的危险因素,包括性别、年龄、吸烟、饮酒、脑卒中史、外周血管病、心脏病、高血压病、糖尿病、血脂血症、狭窄程度、受累血管数和颅内血管代偿程度等,统计学分析,探讨影响低血流动力学的可能因素.结果 支架手术成功41例（97.6%）,脑出血1例（2.4%）;无缺血事件及死亡病例发生.狭窄程度由术前（77.5±17.8）%降至术后残余狭窄（17.5±8.7）%.发生低血流动力学共6例（14.3%）.单因素分析结果显示围手术期颈动脉窦反应的发生与患者的既往卒中史及颅内血管代偿程度可能有关.结论 颈动脉窦部支架置入术围手术期低血流动力学发生率较高,做好术前准备和及时识别处理是改善预后重要举措.
Objective To investigate the incidence of hemodynamic depression （HD） after extracranial carotid stenting and detect the predictors for it. Methods 42 patients with symptomatic carotid artery stenosis of more than 50% diameter reduction admitted to our hospital from 2008-2011 and performed CAS were enrolled in the study. The clinical data of these patients were analyzed and the high risk factors of cardiovascular events （ hypotension or brady- cardia） at the perioperative period were observed. Factors included patient gender, age, smoking, drinking, history of stroke, peripheral vascular disease, heart disease, blood pressure, diabetes, preoperative lipid, the degree of stenosis, the number of involved vessels and the degree of intracranial vascular decompensation. Results The major ad-verse event rate was 2.4%. No patient was complicated with stroke. One patient（2.4% ）suffered from periprocedural ICH. The most frequent intraprocedural complications observed were bradycardia and hypotension. These occurred in 7 patients （ 16.7% ）of 42 patients and required vasopressor support. No significant differences on the clinical data, high risk factors of cardiovascular events and morphological characteristics of the vessels were noted between the two groups （ P 〉 0.05 ）. The operation procedures were almost the same between the two group. Conclusion Hemodynamic de-pression is common after CAS. Management of periprocedural cardiovascular instability represents one of the most im-portant elements in the safe conduct of CAS.
出处
《医学新知》
CAS
2012年第4期270-272,275,共4页
New Medicine
基金
福建省卫生厅青年科研课题基金资助计划（课题编号2011-1-7）
