颈内动脉支架植入术后出血的临床分析

Clinical Analysis of Hemorrhage Following Carotid Artery Stenting

目的:分析颈内动脉支架植入术后出现影响不同部位出血的原因及防治策略。方法:回顾性分析于2010年7月-2015年8月间在本科行颈内动脉支架植入的285例患者的临床资料,分析总结术后短期内发生不同部位出血性并发症的患者的临床特点、治疗方法及预后。结果:285例患者中,7例发生出血性并发症,其中2例颅内出血患者死亡,1例脑出血患者遗留有肢体轻偏瘫,余1例消化道出血、2例假性动脉瘤和1例肾周出血患者经治疗痊愈出院。结论:颈内动脉支架植入术后发生的出血性并发症,采用短期停用抗凝、抗血小板聚集的治疗方案可能改善患者预后。

Objective To investigate the influencing factors and prognosis of hemorrhage in different organs following carotid artery stenting（ CAS）. Methods The clinical data of 285 patients who underwent internal carotid artery stenting in our department from July 2010 to August 2015 were analyzed retrospectively. Clinical characteristics,treatment and prognosis were analyzed and summarized on the patients who had hemorrhagic complications of different sites shortly after operation.Results Of the 285 patients,7 were found with hemorrhagic complications,including 3 cases of intracranial hemorrhage,1 case of upper gastrointestinal hemorrhage,1 case of perinephric hemorrhage and 2 cases of pseudoaneurysm in the puncture area. Of the 7 cases of hemorrhage,two patients with intracranial hemorrhage died,one patient with cerebral hemorrhage had hemiparesis and the rest 4 patients fullly recovered after treatment. Conclusion Short-term discontinuation of anticoagulant and anti-platelet aggregation treatment may improve the prognosis of patients with hemorrhagic complications after internal carotid artery stent implantation.