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目的:研究血管内介入治疗颈动脉、椎动脉狭窄的临床疗效和安全性。方法:选择2011年3月~2016年3月在我院进行诊治的210例颈动脉和椎动脉狭窄患者狭窄程度在70%~99%之间,颈、椎动脉直径狭窄率超过70%,所有患者均进行了血管内介入治疗,观察患者的临床表现、DSA和血管超声检查结果和围手术期并发症,并进行随访。结果:经颈部血管听诊发现,有163例(77.62%)患者出现血管杂音,合并高血压103例(49.05%)、高脂血症123例(58.57%)、吸烟76例(36.19%)、糖尿病98例(46.67%)、高同型半胱氨酸血症13例(6.19%);DSA检查发现有126例患者为单纯颅外段颈动脉狭窄,51例患者为单纯椎动脉起始部狭窄,22例患者为颅外段颈动脉合并椎动脉狭窄;术后的颈、椎动脉平均狭窄率为(4.15±7.26)%,明显低于术前的(79.25±6.34)%(P<0.05);所有患者均未出现严重神经系统并发症和手术期死亡;术后随访8~36个月,均未出现与支架相关的短暂性脑缺血和新发脑梗死。结论:血管内介入治疗颈动脉、椎动脉狭窄安全有效,具有较高的临床应用价值。
Objective: To study the clinical efficacy and safety of endovascular interventional treatment of carotid artery and vertebral artery stenosis. Methods: From March 2011 to March 2016, 210 patients with carotid and vertebral artery stenosis who were diagnosed and treated in our hospital between 70% and 99% stenosis, the stenosis rate of cervical and vertebral arteries exceeded 70% All patients underwent endovascular interventional treatment. The clinical manifestations, DSA, vascular ultrasound findings and perioperative complications were observed and followed up. Results: A total of 163 patients (77.62%) had vascular murmur, 103 cases (49.05%) had hypertension, 123 cases (58.57%) had hyperlipidemia, 76 cases (36.19%) had smoking, 98 cases (46.67%) of diabetes mellitus and 13 cases (6.19%) of hyperhomocysteinemia; only 126 cases of simple extracranial carotid artery stenosis were found by DSA and 51 cases of simple vertebral artery stenosis , And 22 patients had extracranial carotid artery with vertebral artery stenosis. The average stenosis rate of the cervical and vertebral arteries was 4.15 ± 7.26%, which was significantly lower than 79.25 ± 6.34% preoperatively (P <0.05) ; No serious neurological complications and operative death occurred in all patients. No stent-related transient ischemic attack or new-onset cerebral infarction occurred after 8 to 36 months of follow-up. Conclusion: Endovascular treatment of carotid artery, vertebral artery stenosis is safe and effective, with high clinical value.