CAJ | 학술논문

目的：探讨对急性分水岭脑梗死（CWI）伴有责任颈动脉狭窄患者早期行颈动脉支架成形术的安全性及疗效。方法对33例急性CWI患者，在1周内行责任颈动脉狭窄支架成形术，观察患者手术安全性及术后疗效。结果33例患者均顺利完成颈动脉支架成形术，手术成功率为100%。术后23例患者出现不同程度心率减慢、血压下降，给予阿托品、多巴胺等药物后，心率、血压回升。术中1例患者栓子脱落出现脑栓塞，导致对侧肢体偏瘫，经治疗后，对侧肢体肌力改善，恢复至术前水平。术后无一例患者出现同侧大脑半球过度灌注或脑出血。术后30 d患者NHISS评分较术前明显改善，差异有统计学意义（P＜0.05）。结论对于急性CWI患者，早期支架成形术解除责任颈动脉狭窄是安全的，可能改善患者的预后。
목적：탐토대급성분수령뇌경사（CWI）반유책임경동맥협착환자조기행경동맥지가성형술적안전성급료효。방법대33례급성CWI환자，재1주내행책임경동맥협착지가성형술，관찰환자수술안전성급술후료효。결과33례환자균순리완성경동맥지가성형술，수술성공솔위100%。술후23례환자출현불동정도심솔감만、혈압하강，급여아탁품、다파알등약물후，심솔、혈압회승。술중1례환자전자탈락출현뇌전새，도치대측지체편탄，경치료후，대측지체기력개선，회복지술전수평。술후무일례환자출현동측대뇌반구과도관주혹뇌출혈。술후30 d환자NHISS평분교술전명현개선，차이유통계학의의（P＜0.05）。결론대우급성CWI환자，조기지가성형술해제책임경동맥협착시안전적，가능개선환자적예후。
Objective To evaluate the safety and efficacy of early carotid artery stenting in treating cerebral watershed infarction patients with carotid artery stenosis. Methods A total of 33 patients with acute cerebral watershed infarction complicated by carotid artery stenosis received carotid artery stenting within one week after the onset of the disease. The clinical safety and efficacy were evaluated. Results The carotid artery stenting was successfully accomplished in all 33 patients with a success rate of 100%. After the procedure, different degree of bradycardia and hypotension was seen in 23 patients, which restored to normal after prompt medication with atropine, dopamine, etc. During the procedure, one patients developed cerebral embolism due to dislodgment of emboli, resulting in contralateral hemiparalysis, and the contralateral limb muscle strength returned to preoperative status after proper treatment. After the treatment, no ipsilateral hemisphere excessive perfusion or cerebral hemorrhage occurred. Thirty days after the treatment, NHISS scores of the patients were obviously improved, which were significantly different from those determined before the treatment (P<0.05). Conclusion For the treatment of acute cerebral watershed infarction, early carotid artery stenting to relieve carotid artery stenosis is quite safe and it may improve the prognosis as well.