中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
7期
703-706
,共4页
成钢卫%李水彬%罗丽敏%周坤元%朱钦辉
成鋼衛%李水彬%囉麗敏%週坤元%硃欽輝
성강위%리수빈%라려민%주곤원%주흠휘
双导丝%颈动脉%支架植入
雙導絲%頸動脈%支架植入
쌍도사%경동맥%지가식입
Balloon Dilatation%Carotid artery%Stent
目的 研究双导丝合并直型导管交换技术在入路高度迂曲的颈动脉支架植入术中的应用. 方法 梅州市人民医院神经内二科自2005年8月至2013年1月应用双导丝合并直型导管交换技术行颈动脉支架成形术(CAS)治疗颈内动脉起始部重度狭窄患者15例,分析患者的疗效和并发症的发生情况.比较术前和术后3d、1个月后的美国国立卫生研究院卒中量表评分(NIHSS)情况,以及3个月后改良Rankin量表(mRS)评分情况. 结果 15例患者中有13例成功植入支架,其中发生颈动脉窦综合征2例,股动脉鞘管周围术后渗血3例,股动脉漏形成1例.1例患者术后NIHSS降低,但头颅CT未见新发脑梗死；与术前[14(9～17)]比较,15例患者术后1月NIHSS评分[11(8～13)]有所降低,差异有统计学意义(Z=-10.153,P=0.000);患者术后3月mRS评分与术前比较减低,差异有统计学意义(U=2.079,P=0.045). 结论 双导丝合并直管交换技术在入路高度迂曲的颈动脉支架植入术中安全有效.
目的 研究雙導絲閤併直型導管交換技術在入路高度迂麯的頸動脈支架植入術中的應用. 方法 梅州市人民醫院神經內二科自2005年8月至2013年1月應用雙導絲閤併直型導管交換技術行頸動脈支架成形術(CAS)治療頸內動脈起始部重度狹窄患者15例,分析患者的療效和併髮癥的髮生情況.比較術前和術後3d、1箇月後的美國國立衛生研究院卒中量錶評分(NIHSS)情況,以及3箇月後改良Rankin量錶(mRS)評分情況. 結果 15例患者中有13例成功植入支架,其中髮生頸動脈竇綜閤徵2例,股動脈鞘管週圍術後滲血3例,股動脈漏形成1例.1例患者術後NIHSS降低,但頭顱CT未見新髮腦梗死；與術前[14(9～17)]比較,15例患者術後1月NIHSS評分[11(8～13)]有所降低,差異有統計學意義(Z=-10.153,P=0.000);患者術後3月mRS評分與術前比較減低,差異有統計學意義(U=2.079,P=0.045). 結論 雙導絲閤併直管交換技術在入路高度迂麯的頸動脈支架植入術中安全有效.
목적 연구쌍도사합병직형도관교환기술재입로고도우곡적경동맥지가식입술중적응용. 방법 매주시인민의원신경내이과자2005년8월지2013년1월응용쌍도사합병직형도관교환기술행경동맥지가성형술(CAS)치료경내동맥기시부중도협착환자15례,분석환자적료효화병발증적발생정황.비교술전화술후3d、1개월후적미국국립위생연구원졸중량표평분(NIHSS)정황,이급3개월후개량Rankin량표(mRS)평분정황. 결과 15례환자중유13례성공식입지가,기중발생경동맥두종합정2례,고동맥초관주위술후삼혈3례,고동맥루형성1례.1례환자술후NIHSS강저,단두로CT미견신발뇌경사；여술전[14(9～17)]비교,15례환자술후1월NIHSS평분[11(8～13)]유소강저,차이유통계학의의(Z=-10.153,P=0.000);환자술후3월mRS평분여술전비교감저,차이유통계학의의(U=2.079,P=0.045). 결론 쌍도사합병직관교환기술재입로고도우곡적경동맥지가식입술중안전유효.
Objective To explore whether straight guiding catheter exchange assisted by double guidewire can slove the difficult problem of the guiding catheter being unable to enter the right carotid artery in patients with carotid stenosis via circuitous approach.Methods Fifteen patients with severe carotid stenosis,admitted to our hospital from August 2005 to January 2013,were chosen in our study; they were performed straight guiding catheter exchange assisted by double guidewire.Secondary carotid sinus syndrome,puncture wound,acute coronary syndrome,cerebral infarction and cerebral hemorrhage in the postprocedural period were observed; National Institutes of Health Stroke Scale (NIHSS) scores 3 and 30 days after the surgery were recorded and compared; meanwhile,modified Rankin Scale (mRS) scores 3 months after the surgery were compared.Results With the techniques of straight guiding catheter exchange assisted by double guidewire,13 patients were successfully implanted carotid artery stent among the 15 patients.Two patients had secondary carotid sinus syndrome,3 had femoral sheath around postoperative bleeding and 1 had femoral artery fistula during the 13 patients.The NIHSS scores in 1 patient decreased after the operation,but new infarction lesion was not found in the head CT.The NIHSS scores 30 days after the surgery [11 (8-13)] were significantly lower than the preoperative NIHSS scores [14(9-17)] (Z=-10.153,P-0.000).The mRS scores 3 months after the surgery was significantly improved as compared with those before surgery (U=2.079,P=-0.045).Conclusion The application of straight guiding catheter exchange assisted by double guidewire is safe and effective in the carotid-artery stenting via circuitous approach.
