影响颈动脉支架植入术后血流动力学稳定性的危险因素分析及对预后的影响

Risk factors of hemodynamic stability after carotid artery stent implantation and their effect on prognosis

目的探讨影响颈动脉支架植入术(CAS)后血流动力学稳定性的危险因素及对预后的影响。方法选取2019年1月至2021年2月新乡市中心医院收治的CAS患者50例,根据是否出现血流动力学损害分为两组,分析影响患者血流动力学的危险因素及其对患者预后质量的影响。结果单因素分析结果方面,高血压病史、冠心病史、重度狭窄、颈动脉斑块回声伴钙化、球囊后扩张、扩张率≥70%以及采用开环支架等因素是患者术后出现血流动力学损害的危险因素(P<0.05);多因素Logistic回归分析结果显示,球囊后扩张、采用开环支架是患者术后出现血流动力学损害的危险因素(P<0.05);预后质量方面,两组患者术后1年内卒中以及终点事件发生率比较,差异无统计学意义(P>0.05),同时血流动力学损害组患者的住院天数多于非血流动力学损害组患者(P<0.05)。结论 CAS术后出现血流动力学损害的危险因素是重度狭窄和球囊后扩张,这就需要医务人员为患者提供针对性干预,改善患者的预后质量。

【Objective】 To explore the risk factors affecting hemodynamic stability after carotid stent implantation(CAS) and their effect on the prognosis. 【Methods】 From January 2019 to February 2021, 50 cases of patients with CAS were divided into two groups according to whether the hemodynamic damage(damage to blood flow dynamics) occurred, the risk factors affecting hemodynamics in patients and thier effect on the prognosis quality of patients were analyzed. 【Results】 In the results of single factor analysis, history of hypertension, history of coronary heart disease, severe stenosis, carotid plaque echo with calcification,post-balloon dilatation, dilatation rate ≥70% and open-loop stent were the risk factors for postoperative hemodynamic damage(P<0.05).Multifactor logistic regression analysis showed that the risk factors of hemodynamic damage in patients were post-balloon dilatation and open-loop stent(P<0.05). In terms of prognosis quality, there was no significant difference between the two groups in the incidence of stroke and endpoint events within 1 year after operation(P>0.05), and the length of hospital stay was longer in patients with hemodynamic damage than patients without hemodynamic damage(P<0.05). 【Conclusion】 Postoperative hemodynamic damage factors in the CAS is severe stenosis and post-balloon expansion, which will require medical staff to provide targeted interventions for patients, improve the prognosis quality of patients.