颈动脉支架置入术后并发症及处理方法

Complications of carotid artery stenting and their management

目的探讨颈动脉支架置入术后并发症特点及处理方法。方法收集解放军总医院2012年1月~2014年10月收治的颈动脉狭窄并行颈动脉支架置入术患者92例,分析颈动脉支架置入术后相关并发症及处理方法。结果92例患者均成功置入颈动脉支架,手术成功率为100%,术后残余狭窄率〈10%;共有13例患者出现并发症（14.1%）,其中术后发生视力下降2例,经提高血压、扩张微循环、营养神经治疗后好转;造影剂过敏反应1例,给予吸氧、补液处理后症状消失;消化道出血2例,给予禁食水,补液及应用抑制胃酸和止血药物等对症处理,出血均得到控制;颈动脉窦综合征5例;脑过度灌注综合征3例,其中颅内出血2例,行开颅手术治疗后死亡1例、植物人1例,另外1例出现头痛,对症处理后症状消失。结论详细的病史采集及完善术前相关检查,掌握并发症的发病原因及临床表现,并给予正确的处理,可以预防和降低并发症的发生。

Objective To study the complications of carotid artery stenting and their management. Methods Ninety-two carotid stenosis patients admitted to Chinese PLA General Hospital from January 2012 to October 2012 for carotid artery stenting were included in this study. The compli- cations of carotid artery stenting and their management were analyzed. Results The carotid artery stenting was a 100% success with its residual stenosis 〈10%. The vision was decreased in 2 pa- tients,anaphylactic reaction to contrast medium occurred in 1 patient, digestive tract hemorrhage was detected in 2 patients, carotid sinus syndrome was found in 5 patients, hyperperfusion syn- drome was found in 3 patients. Their symptoms disappeared after expectant treatment. Complica- tions occurred in 13 patients, accounting for 14.1% of the total patients. Conclusion Detailed medical history collection,careful perioperative examination, understanding the reasons why com- plications occur and the methods for their management can effectively prevent and reduce the inci- dence of stenting-related complications.