大脑中动脉成形术治疗中、重度残疾的皮质下分水岭梗死的临床观察

Clinical observation of middle cerebral artery angioplasty in treatment of subcortex cerebral watershed infarction with moderate or severe disabilities

目的：评价大脑中动脉成形术治疗皮质下分水岭梗死（subcortex cerebral watershed infarction,S-CWI）导致中、重度残疾的患者的安全性和有效性.方法：2011年6月至2012年5月北京大学第三医院介入血管外科治疗的合并同侧大脑中动脉重度狭窄的中、重度残疾的S-CWI患者5例（6处病变）,观察5例患者术前及术后神经系统评分,并评价神经功能的改善情况.结果：5例患者术后第7天神经功能均有改善,美国国立卫生研究院卒中量表（National Institute of Health Stroke Scale,NIHSS）评分下降4～6分,改良Rankin量表（Modified Rankin Scale,mRs）评分下降1分;3个月随访时4例患者mRs评分为1分,1例患者为2分.1年随访时无新发卒中及支架内再狭窄事件.结论：大脑中动脉成形术对因S-CWI所致中重度残疾的患者有益.

Objective：To assess the safety and effectiveness of middle cerebral artery angioplasty in treatment of subcortical watershed infarcts （S-CWI） with moderate or severe disabilities. Methods：From June 2011 to May 2012, 5 S-CWI patients （six lesions） with moderate or severe disabilities combining severe stenosis in Ipsilateral middle cerebral artery received middle cerebral artery angioplasty in Inter- ventional Radiology and Vascular Surgery Department, Peking University Third Hospital. We observed the neurological score before and after angioplasty and assessed the improvement of neurological func- tions. Results：The National Institute of Health stroke scale （NIHSS） scores were decreased by 4 -6 points and modified Rankin scale（mRs） scores were decreased 1 point in 7 days. In the 3 months＇ fol- low-up, 4 patients＇ mRs scores were 1 point, and 1 patient＇ s was 2 points. In the 1-year follow-up, there were no new strokes and in-stent restenosis events. Conclusion： Middle cerebral artery angioplasty in treatment of S-CWI with moderate or severe disabilities is beneficial.