椎动脉支架成形术治疗椎动脉狭窄的临床观察

Clinical observation of vertebral artery stent in the treatment of vertebral artery stenosis

目的探讨椎动脉支架成形术治疗椎动脉狭窄的效果和价值,为临床治疗提供参考依据。方法对44例椎动脉狭窄患者进行椎动脉支架成形术治疗,术后进行随访观察手术成功率、术前及术后椎动脉血管狭窄率,随访时采用Malek评分来评价患者治疗效果。结果 44例患者50条狭窄动脉成功置入支架50支,所有支架定位准确,术后造影残余狭窄率≤30%,手术成功率为100%。术前各动脉的狭窄率为(72.4±4.6)%,术后平均残余狭窄率为(11.9±1.5)%,术前与术后相比,狭窄率的差异具有显著性(t=7.254,P<0.001),术后动脉狭窄明显改善。术后3个月对44例患者进行随访,Malek评分为1分者21例;2分者15例;3分者8例;无评分为4分及5分者。结论椎动脉支架成形术治疗椎动脉狭窄疗效确切,具有重要的临床价值,但长期随访的疗效还有待今后进一步验证。

Objective Investigate vertebral artery stenting for stenosis of the vertebral artery and the value,provides the reference for the clinical treatment.Methods 44 Patients into the vertebral artery stenting treatment,the patients were followed up to observe the success rate of operation,preoperative and postoperative vertebral artery stenosis,follow-up malek score to evaluate the curative effect of patients.Results The 44 patients 50 narrow artery stent implantation 50,all stent positioning accuracy,postoperative angiography residual stenosis ≤ 30%,the success rate of operation was 100%.Each artery stenosis rate preoperatively was（72.4±4.6）%,the average postoperative residual stenosis was（11.9±1.5）%,preoperative and postoperative compared,differences in the stenosis rate have statistical significance（t=7.254,P0.001）,postoperative arterial stenosis was improved.3 months after the surgery of 44 patients were followed up,malek score was 21 cases with 1 points,15 cases with 2 points,8 cases with 3 points,no score to 4 points and 5 points.Conclusion The vertebral artery stenting treatment method is effective in the treatment of vertebral artery stenosis,It has important clinical value,but the effect of long-term follow-up remains to be further verified.