缺血性脑卒中患者颈动脉内膜切除术后脑血管并发症的影响因素研究

Study on Influencing Factors of Cerebrovascular Complications after Carotid Endarterectomy in Patients with Cerebral Ischemic Stroke

目的:研究缺血性脑卒中(CIS)患者经颈动脉内膜切除术(CEA)治疗后出现脑血管并发症的相关影响因素,为后续CIS患者的CEA治疗提供参考。方法:回顾性分析2017年7月-2021年6月佳木斯市中心医院收治的47例CIS患者的临床资料。根据是否发生术后并发症进行分组,将患者分为并发症组与正常组,对比两组各项指标的差异,再通过logistic回归分析探讨CEA术后并发症的影响因素。结果:单因素分析显示,两组阻断前-收缩压、阻断-收缩压最大、阻断-收缩压最小、反流压比较,差异均有统计学意义(P<0.05)。logistic回归分析显示,阻断前-收缩压、反流压是术后并发症的独立危险因素(P<0.05)。结论:阻断前-收缩压、反流压是CIS患者CEA术后发生高灌注、脑出血等并发症的独立危险因素,围手术期应加强患者反流压及血压水平的监测,以降低术后并发症风险。

Objective: To study the related influencing factors of cerebrovascular complications after carotid endarterectomy(CEA) in patients with cerebral ischemic stroke(CIS), and provide reference for CEA treatment in subsequent CIS patients. Method: The clinical data of 47 patients with CIS who were admitted to Jiamusi Central Hospital from July 2017 to June 2021 were analyzed retrospectively. According to whether there was postoperative complication or not, the patients were divided into complication group and normal group. the differences of each index between the two groups were compared, and then the influencing factors of CEA postoperative complications were discussed through logistic regression analysis. Result: Single factor analysis showed that the pre-blocking systolic blood pressure, maximum blocking systolic blood pressure, minimum blocking systolic blood pressure and reflux pressure between the two groups were statistically significant(P<0.05). logistic regression analysis showed that pre-blocking systolic blood pressure and reflux pressure were the independent risk factors for postoperative complications(P<0.05). Conclusion: Pre-blocking systolic blood pressure and reflux pressure are the independent risk factors for complications such as high perfusion and cerebral hemorrhage in CIS patients after CEA operation. In order to reduce the risk of postoperative complications, the monitoring of patients’ blood pressure and blood pressure should be strengthened during the perioperative period.