颅外段颈动脉粥样硬化重度狭窄病变的药物与血管内介入治疗对比

Comparison of drug treatment and interventional therapy for severe stenosis of extracranial carotid atherosclerosis

目的 探讨药物和血管内介入治疗在颅外段颈动脉粥样硬化重度狭窄病变治疗方面的临床效果差异。方法 选取2015-09—2018-05漯河市中心医院收治的颅外段颈动脉粥样硬化重度狭窄病变患者82例,按照采用治疗方法的不同分为观察组(同时接受介入治疗和药物治疗)和对照组(只采用药物治疗),分析临床治疗效果;根据介入治疗所选血管是否为责任血管将观察组分为责任血管组和非责任血管组,对其脑血管事件发生情况进行分析。结果 2组在接受治疗后3个月内其病死率无明显差异(P>0.05),但观察组脑血管事件总发生率(2.44%)明显低于对照组(19.51%),差异有统计学意义(P<0.05);2组治疗后12个月内病死率无明显差异(P>0.05),但观察组脑血管事件总发生率(12.20%)明显低于对照组(41.46%),差异有统计学意义(P<0.05);责任血管组和非责任血管组术后12个月时病死率和脑血管事件总发生率并无明显差异(P>0.05)。结论 在颅外段颈动脉粥样硬化重度狭窄病变治疗中,血管内介入治疗可有效降低患者近期和远期脑血管事件的发生风险,且治疗方案安全可靠,有利于改善患者预后,对于提高其生活质量具有十分积极的意义。

Objective To explore the clinical effect of drug and intravascular interventional therapy in the treatment of extracranial carotid atherosclerosis severe stenosis. Methods Eighty two patients with severe stenosis of the extracranial carotid atherosclerosis admitted to the Luohe Central Hospital of eptember 2015-May 2018 were selected and divided into observation group (simultaneously receiving interventional therapy and drug treatment) and control according to different treatment methods.The group (only treated with drugs), retrospective analysis of its clinical treatment effect;and according to the interventional treatment of the selected blood vessels as the responsible blood vessels, the observed components were the responsible vascular group and the non responsible vascular group, and observed the occurrence of cerebrovascular events analysis. Results There was no significant difference in mortality between the two groups within 3 months after treatment ( P >0.05),but the total incidence of cerebrovascular events in the observation group (2.44%) was significantly lower than that of the control group (19.51%),the difference was statistically significant ( P <0.05);there was no significant difference in mortality between the two groups after 12 months of treatment ( P >0.05),but the total incidence of cerebrovascular events in the observation group (12.20%) was significantly lower than the control group (41.46%),the difference was statistically significant ( P <0.05);the mortality rate of the responsible vascular group and the non responsible vascular group at 12 months after surgery There was no significant difference in the overall incidence of cerebrovascular events ( P >0.05). Conclusion In intracranial carotid artery atherosclerosis severe stenosis lesions,compared with drug therapy,endovascular intervention can effectively reduce the risk of short and long term cerebral vascular events,Prognosis,to improve their quality of life has a very positive significance.