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目的:探究在椎基底动脉支架置入前后血流动力学的变化情况。方法 :选取2013年11月至2015年4月椎基底动脉狭窄患者60例作为研究对象,所有患者均经数字减影血管造影(DSA)证实,运用DSA筛选症状性椎基底动脉狭窄,在DSA下行血管成形术,通过支架置入手术前后对患者进行经颅多普勒超声(TCD)、计算机断层扫描(CTP)以及血液流变学的检测,评估支架置入手术前后对比剂在脑内的灌注变化,同时按照血流灌注积分表获得具体分值以及血流动力学、血液流变学的变化情况。结果:60例患者进行支架放置一共73个,患者在支架放置后其血管内径明显增加,同时患者手术前其患侧的收缩期血流速度峰值明显高于健侧,椎间隙段的收缩期峰值流速(PSV)也明显低于健侧,患者术后其椎动脉起始段的PSV基本恢复正常,椎间隙段的最大峰值时间(PI)值也有明显提升,通过对供血区域相应的灌注参数进行统计分析,患者在术后其灌注参数也有明显的提高,差异具有统计学意义(P<0.05)。结论 :在椎基底动脉狭窄或者闭塞患者的动脉支架植入后可见患者血流动力学相关指标有明显改善,优化患者的机体状况。
Objective: To investigate the changes of hemodynamics before and after vertebrobasilar stent implantation. Methods: Sixty patients with vertebrobasilar artery stenosis from November 2013 to April 2015 were selected as the study subjects. All patients were confirmed by digital subtraction angiography (DSA). DSA was used to screen the symptomatic vertebrobasilar artery stenosis. Angioplasty, transcranial Doppler ultrasound (TCD), computed tomography (CTP), and hemorheology were measured before and after stent implantation to assess intracranial perfusion of contrast media before and after stenting Changes, at the same time according to the perfusion score table to obtain specific scores and hemodynamic, hemorheological changes. Results: A total of 73 scaffolds were placed in 60 patients. The diameter of blood vessels in patients with scoliosis was significantly increased after stent placement. The systolic blood flow velocity peaked at the affected side was significantly higher than that at uninjured side and intervertebral space The velocity of flow (PSV) was also significantly lower than that of the contralateral side. The PSV of the initial segment of vertebral artery in patients returned to normal after operation, and the maximum peak time (PI) value of intervertebral segments also increased significantly. The corresponding perfusion parameters Statistical analysis, patients after perfusion parameters also significantly improved, the difference was statistically significant (P <0.05). CONCLUSIONS: In the patients with vertebrobasilar artery stenosis or occlusion, the hemodynamic indices were significantly improved and the patient’s body condition was optimized.