55例血管内支架成形术治疗颅内动脉狭窄的临床研究

Clinical study of 55 cases of endovascular stenting of intracranial arterial stenosis

目的探讨血管内支架成形术治疗颅内动脉狭窄的安全性以及近期疗效。方法对梅州市人民医院2011年9月至2013年9月收治的55例颅内动脉狭窄患者,根据血管数字减影血管造影（DSA）结果,将其分为前循环组28例和后循环组27例,进行血管内支架成形术治疗。结果手术前后患者动脉狭窄程度比较,前循环组手术前和手术后的动脉狭窄程度分别为（75.16±8.52）%和（13.21±4.56）%,后循环组的手术前和手术后的动脉狭窄程度分别为（76.24±7.98）%和（12.88±3.57）%,手术前后比较差异有统计学意义（P〈0.05）,而前循环组与后循环组比较,差异无统计学意义（P〉0.05）;两组患者手术前后神经功能缺损评分（NIHSS）比较差异亦有统计学意义（P〈0.05）。本研究随访6-12个月,55例患者均获得随访,所有患者均行血管DSA检查,随访期间无患者死亡;两组患者术后6个月和术后12个月改良Rankin量表（m RS）评分以及Barthel指数（BI）评分均较术前有显著的改善（P〈0.05）。结论血管内支架成形术在近期有助于颅内动脉狭窄患者的恢复。

Objective To investigate the endovascular stenting safety and efficacy of the recent intracranial arterial stenosis. Method 55 cases of intracranial arterial stenosis in our hospital from September 2011 to September 2013 were treated according to the results of the blood vessel DSA,and divided into anterior circulation group with 28 cases and posterior circulation group with 27 cases. Results Before and after surgery in patients with the arterial stenosis of anterior circulation group before and after surgery were（ 75. 16 ± 8. 52） % and（ 13. 21 ± 4. 56） %, respectively; arterial stenosis of posterior circulation group before and after surgery were（76.24 ±7.98）% and（12.88 ±3.57）%,respectively.The differences before and after surgery were significant（P〈0.05）,while there were no significant difference between the anterior circulation group and the posterior circulation loop group（P〉0.05）. The National Institutes of Health Stroke Scale（NIHSS） before and after surgery were significantly different（P〈0.05）. This study was followed up for 6-12 months; 55 patients were followed up, all patients underwent vascular DSA examination, no patients died during follow-up; BI and m RS scores of two patients after six months and after 12 months were significantly improved（P〈0.05）. Conclusion Stent angioplasty was effective in the treatment of intracranial arterial stenosis and can help the recovery of patients.