药物球囊预扩联合支架置入治疗椎动脉狭窄患者中专项管理方案的构建与应用

Drug balloon pre-dilation combined with stent implantation in patients with vertebral artery stenosis:Construction of a special management plan and its validation

目的 研究药物球囊联合支架置入治疗椎动脉狭窄患者中专项管理方案的构建及应用效果。方法 纳入2020年1月至2021年6月收治的椎动脉狭窄行药物球囊预扩联合支架置入治疗的患者共计96例为研究对象。将患者以数字表法随机分为观察组与对照组,每组48例。对照组实施常规管理方案,观察组实施专项管理方案,对比不同管理方案对2组患者临床康复效果的影响。结果 干预后观察组上消化道出血率、住院费用均低于对照组(P<0.05),住院时间短于对照组(P<0.05);干预前2组患者三酰甘油、胆固醇与低密度脂蛋白水平无明显差异(P>0.05),干预后观察组指标水平均低于对照组(P<0.05);干预后观察组患者服药依从率与运动锻炼依从率显著高于对照组(P<0.05);干预前2组患者生活质量及家庭亲密度与适应性量表得分均无明显差异(P>0.05),干预后观察组患者上述量表得分均高于对照组(P<0.05);干预前2组患者焦虑与抑郁量表得分均无明显差异(P>0.05),干预后观察组患者焦虑与抑郁量表得分均低于对照组(P<0.05);连续随访1年,观察组患者椎动脉再狭窄率低于对照组(P<0.05)。结论 在接受药物球囊预扩联合支架置入术治疗的椎动脉狭窄患者中应用专项管理方案能够改善患者的临床指标,降低血脂指标水平与再狭窄率,提升患者生活质量、心理状况及家庭功能。

Objective To construct a special management plan of drug balloon pre-dilation combined with stent implantation in patients with vertebral artery stenosis and to validate its outcome.Methods A total of 96 patients with vertebral artery stenosis and treated with drug balloon pre-dilation combined with stent placement from January 2020 to June 2021 were included in the study.They were randomly assigned into the observation group and control group using a number table method,with 48 cases in each group.A routine management plan,and a special management plan were implemented in the control group and observation group,respectively.Clinical rehabilitation effect was compared between groups.Results After interventions,the upper gastrointestinal bleeding rate and hospitalization cost in the observation group were significantly lower than those of the control group(P<0.05),and the length of stay was significantly shorter than that of the control group(P<0.05).There were no significant differences in the levels of triglyceride,cholesterol and low density lipoprotein before the intervention between the two groups(P>0.05),which,after the intervention,were significantly lower in the observation group than those of the control group(P<0.05).After the intervention,the compliance rate of medication and exercise in the observation group was significantly higher than that of the control group(P<0.05).There were no significant differences in the scores of quality of life,family cohesion and adaptability before the intervention between the two groups(P>0.05),which,after the intervention,were significantly higher in the observation group than those of the control group(P<0.05).There were no significant difference in the scores of anxiety and depression before the intervention between the two groups(P>0.05),which,after the intervention,were significantly lower in the observation group than those of the control group(P<0.05).The rate of vertebral artery restenosis after a continuous follow-up of 1 year in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The application of a special management plan in patients with vertebral artery stenosis treated by drug balloon pre-dilation combined with stent implantation can improve the clinical indicators,quality of life,psychological status and family function,and reduce the levels of blood lipid indicators and restenosis rate.