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目的观察经皮腔内支架成形术(percutaneous transluminal angioplasty and stenting,PTAS)治疗动脉狭窄性缺血性脑血管病患者的临床疗效,探讨其有效性及安全性。方法对2004年3月~2007年2月新疆医科大学第一附属医院19例接受PTAS治疗的动脉狭窄性缺血性脑血管病患者进行回顾性分析。19例患者共放置支架20枚。术后1周复查全脑血管造影,并于术前及术后1周对患者进行美国国立卫生研究院卒中量表(NIHSS)评分比较,并进行统计学分析。结果手术成功率为100%。经过治疗的血管狭窄程度均明显改善,残余狭窄程度<20%。围手术期患者症状消失和改善17例(89%);术后同侧卒中2例(11%)。患者NIHSS评分术后较术前明显降低,差异有统计学意义(P<0.05)。结论 PTAS可以明显改善动脉狭窄性缺血性脑血管病患者的神经功能缺损程度,手术成功率高,并发症发生率低,临床效果满意,是一种安全、有效的治疗方法,但中远期疗效有待进一步观察。
Objective To observe the clinical efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with arterial stenosis ischemic cerebrovascular disease, and to explore its effectiveness and safety. Methods From March 2004 to February 2007, 19 patients with arterial stenosis ischemic cerebrovascular disease undergoing PTAS in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. A total of 19 patients placed stent 20. One week after operation, whole cerebrovascular angiography was reviewed. NIHSS scores were compared and statistically analyzed before and 1 week after surgery. Results The success rate of surgery was 100%. Treated vascular stenosis were significantly improved, the degree of residual stenosis <20%. Perioperative symptoms disappeared and improved in 17 cases (89%); postoperative ipsilateral stroke in 2 cases (11%). The NIHSS score of patients was significantly lower than that before operation, the difference was statistically significant (P <0.05). Conclusion PTAS can significantly improve the degree of neurological deficits in patients with stenosis ischemic cerebrovascular disease. The high success rate of surgery, low complication rate and satisfactory clinical results are a safe and effective treatment method. However, Curative effect needs further observation.