脑血管支架植入手术治疗缺血性脑血管病48例临床分析

Clinical analysis of 48 cerebrovascular stent implantations for ischemic cerebral vascular disease

目的探讨脑血管支架植入手术治疗缺血性脑血管病的疗效及并发症处理,以提高临床治疗水平。方法回顾性分析中国人民解放军第六十中心医院收治的48例缺血性脑血管病患者的脑血管病发生风险因素、脑血管病变、脑血管支架植入手术情况、术后并发症处理及预后等指标。结果 48例患者术后血管狭窄减少均在70%以上,术后并发症6例:应激性失明1例,继发性癫痫大发作2例,颈动脉窦反应2例,颅内出血2例;47例患者术后1个月回访均无明显不适症状,15例患者术后0.5~2a行DSA复查:12例支架形态、位置良好,3例出现支架内再狭窄。结论头颅影像学、颈部血管超声、DSA等检查可早期筛查发现脑血管病变,脑血管支架植入及球囊扩张手术可有效缓解脑血管狭窄恢复脑供血,全面的术前评估、严格的围手术期治疗护理以及术后定期复查DSA能有效降低术后并发症的发生。

Objective We investigated treatment effect and complication of cerebrovascular stent implantation for ischemic cerebral vascular disease in order to increase the level of treatment.Methods We made a retrospective analysis of occurring risk,cerebrovascular lesion,stent implantation,complication treatment and prognosis of 48 patients undergone ischemic cerebral vascular disease in our department.Results The decreasing degree of angiostenosis were all above 70 percent and there were 6 complications occurred after surgery(1 stress blindness,2 major epileptic seizures,2 carotid sinus reaction and 2 cerebral hemorrhage),47 patients undergone surgery had no obvious discomfort in return visit 1 month later and 15 patients were detected good shape and position of implanted stents 6 months to 2 years later via DSA but 3 patients had in stent restenosis.Conclusion Cerebral imaging examination,cervical vascular ultrasound and DSA can detect cerebrovascular lesion at an early stage,cerebrovascular stent implantation and balloon inflation surgery can relieve angiostenosis and improve blood supplement effectively,and besides,an overall evaluation before surgery,strict care around surgery and regular check for DSA after surgery can decrease complication effectively.