国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
1期
82-85
,共4页
颅外颈动脉狭窄%支架成形术
顱外頸動脈狹窄%支架成形術
로외경동맥협착%지가성형술
Extracranial carotid stenosis%Stent angioplasty
目的 总结经皮血管内支架成形术治疗颅外颈动脉狭窄的临床应用体会.方法 回顾性研究2009年1月至2011年12月在我院行经皮血管内支架成形术治疗颅外颈动脉狭窄的52例患者的临床资料,分析狭窄血管特点和手术成功率、评价血管狭窄纠正情况、症状改善情况和并发症情况.结果 血管狭窄程度为极重度5例、重度36例、中度11例,狭窄部位颈内动脉40例、颈总动脉3例、分叉部5例、高于颈2水平的颅外段狭窄4例；共对52例患者放置56枚自膨胀式支架,手术成功率为96.2％(50/52);术中造影见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的有49例,症状改善率为94.2％；术后发生并发症3例,占5.8％.结论 根据颈动脉狭窄程度、血管解剖条件和全身耐受手术情况等适应症选择支架成形术治疗颅外颈动脉狭窄,可有效对血管扩张成形、纠正颈动脉管腔狭窄、改善临床症状,具有手术成功率高、并发症发生率低、术后缺血性卒中发生率较低等优点,是一种安全、有效的治疗方法.
目的 總結經皮血管內支架成形術治療顱外頸動脈狹窄的臨床應用體會.方法 迴顧性研究2009年1月至2011年12月在我院行經皮血管內支架成形術治療顱外頸動脈狹窄的52例患者的臨床資料,分析狹窄血管特點和手術成功率、評價血管狹窄糾正情況、癥狀改善情況和併髮癥情況.結果 血管狹窄程度為極重度5例、重度36例、中度11例,狹窄部位頸內動脈40例、頸總動脈3例、分扠部5例、高于頸2水平的顱外段狹窄4例；共對52例患者放置56枚自膨脹式支架,手術成功率為96.2％(50/52);術中造影見血管狹窄程度均明顯改善,殘餘狹窄程度＜20％；圍手術期患者癥狀消失和改善的有49例,癥狀改善率為94.2％；術後髮生併髮癥3例,佔5.8％.結論 根據頸動脈狹窄程度、血管解剖條件和全身耐受手術情況等適應癥選擇支架成形術治療顱外頸動脈狹窄,可有效對血管擴張成形、糾正頸動脈管腔狹窄、改善臨床癥狀,具有手術成功率高、併髮癥髮生率低、術後缺血性卒中髮生率較低等優點,是一種安全、有效的治療方法.
목적 총결경피혈관내지가성형술치료로외경동맥협착적림상응용체회.방법 회고성연구2009년1월지2011년12월재아원행경피혈관내지가성형술치료로외경동맥협착적52례환자적림상자료,분석협착혈관특점화수술성공솔、평개혈관협착규정정황、증상개선정황화병발증정황.결과 혈관협착정도위겁중도5례、중도36례、중도11례,협착부위경내동맥40례、경총동맥3례、분차부5례、고우경2수평적로외단협착4례；공대52례환자방치56매자팽창식지가,수술성공솔위96.2％(50/52);술중조영견혈관협착정도균명현개선,잔여협착정도＜20％；위수술기환자증상소실화개선적유49례,증상개선솔위94.2％；술후발생병발증3례,점5.8％.결론 근거경동맥협착정도、혈관해부조건화전신내수수술정황등괄응증선택지가성형술치료로외경동맥협착,가유효대혈관확장성형、규정경동맥관강협착、개선림상증상,구유수술성공솔고、병발증발생솔저、술후결혈성졸중발생솔교저등우점,시일충안전、유효적치료방법.
Objective To summarize the experience in clinical application of percutaneous transluminal stent angioplasty in the treatment of extracranial carotid stenosis.Methods The clinical data on 52 patients with extracranial carotid stenosis who had undergone percutaneous transluminal stent angioplasty in our hospital during January 2009 to December 2011 were retrospectively reviewed.The characteristics of the narrowing vessels and the success rate of surgery were analyzed ; correction of vascular stenosis,improvement in clinical symptoms,and incidence of complications were assessed.Results Vascular stenosis was extremely severe in 5 patients,severe in 36,and moderate in 11.Stenosis at internal carotid artery was found in 40 patients,stenosis at common carotid artery in,stenosis at furcation in 5,and stenosis at extracranial carotid artery higher than cervical 2 in 4.56 self-expandable metallic stents were implanted in 52 patients,with a success rate of 96.2％ (50/52).Intraoperative angiography showed the stenotic degree was significantly improved and the percentage of residual stenosis was less than 20％.Symptoms disappeared or improved in 49 patients during the perioperative period,with a rate of 94.2％.Complications occurred postoperatively in 3 patients (5.8％).Conclusions Selection of self-expandable stent therapy for extracranial carotid stenosis according to the surgical indications including degree of carotid artery stenosis,vascular anatomy and body tolerance to surgery can effectively expand vessels,correct of vascular stenosis,and relieve clinical symptoms.The procedure has a higher success rate,lower incidence rates of complications and postoperative ischemic stroke,being an effective and safe therapeutic method for extracranial carotid stenosis.
