实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
8期
50-53
,共4页
椎底动脉供血不足%支架%药物疗法%疗效比较研究
椎底動脈供血不足%支架%藥物療法%療效比較研究
추저동맥공혈불족%지가%약물요법%료효비교연구
Vertebrobasilar insufficiency%Stents%Drug therapy%Comparative effectiveness research
目的：比较药物疗法与支架成形术治疗重度椎动脉起始部狭窄（ VAOS ）的临床疗效。方法选择2012年1月—2014年1月在沧州市人民医院神经内科住院治疗的重度VAOS患者96例，采用随机数字表分为观察组和对照组，各48例。对照组患者采用药物疗法，观察组患者采用支架成形术。比较两组患者治疗前和出院后12个月血管狭窄率和NIHSS评分；比较两组患者出院后12个月血管闭塞、新发脑梗死和短暂性脑缺血发作（ TIA）发生率；并观察支架成形术治疗的安全性。结果治疗前两组患者血管狭窄率和 NIHSS 评分比较，差异无统计学意义（ P >0.05）；出院后12个月，观察组患者血管狭窄率、NIHSS评分及血管闭塞、新发脑梗死、TIA发生率均低于对照组（ P<0.05）。观察组患者手术成功率为97.9%，围术期均未出现严重并发症，出院后12个月椎动脉起始部再狭窄发生率为27.1%。结论支架成形术治疗重度VAOS的临床疗效优于药物疗法，能有效缓解患者血管狭窄、改善患者神经功能，安全性高，但术后再狭窄发生率较高。
目的：比較藥物療法與支架成形術治療重度椎動脈起始部狹窄（ VAOS ）的臨床療效。方法選擇2012年1月—2014年1月在滄州市人民醫院神經內科住院治療的重度VAOS患者96例，採用隨機數字錶分為觀察組和對照組，各48例。對照組患者採用藥物療法，觀察組患者採用支架成形術。比較兩組患者治療前和齣院後12箇月血管狹窄率和NIHSS評分；比較兩組患者齣院後12箇月血管閉塞、新髮腦梗死和短暫性腦缺血髮作（ TIA）髮生率；併觀察支架成形術治療的安全性。結果治療前兩組患者血管狹窄率和 NIHSS 評分比較，差異無統計學意義（ P >0.05）；齣院後12箇月，觀察組患者血管狹窄率、NIHSS評分及血管閉塞、新髮腦梗死、TIA髮生率均低于對照組（ P<0.05）。觀察組患者手術成功率為97.9%，圍術期均未齣現嚴重併髮癥，齣院後12箇月椎動脈起始部再狹窄髮生率為27.1%。結論支架成形術治療重度VAOS的臨床療效優于藥物療法，能有效緩解患者血管狹窄、改善患者神經功能，安全性高，但術後再狹窄髮生率較高。
목적：비교약물요법여지가성형술치료중도추동맥기시부협착（ VAOS ）적림상료효。방법선택2012년1월—2014년1월재창주시인민의원신경내과주원치료적중도VAOS환자96례，채용수궤수자표분위관찰조화대조조，각48례。대조조환자채용약물요법，관찰조환자채용지가성형술。비교량조환자치료전화출원후12개월혈관협착솔화NIHSS평분；비교량조환자출원후12개월혈관폐새、신발뇌경사화단잠성뇌결혈발작（ TIA）발생솔；병관찰지가성형술치료적안전성。결과치료전량조환자혈관협착솔화 NIHSS 평분비교，차이무통계학의의（ P >0.05）；출원후12개월，관찰조환자혈관협착솔、NIHSS평분급혈관폐새、신발뇌경사、TIA발생솔균저우대조조（ P<0.05）。관찰조환자수술성공솔위97.9%，위술기균미출현엄중병발증，출원후12개월추동맥기시부재협착발생솔위27.1%。결론지가성형술치료중도VAOS적림상료효우우약물요법，능유효완해환자혈관협착、개선환자신경공능，안전성고，단술후재협착발생솔교고。
Objective To compare the clinical effect on severe vertebral artery origin stenosis( VAOS) between drug therapy and stent-assisted angioplasty. Methods From January 2012 to January 2014,a total of 96 patients with severe VAOS were selected in the Department of Neurology,Cangzhou People′s Hospital,and they were randomly divided into control group and observation group,each of 48 cases. Patients of control group were treated by drug therapy,while patients of observation group were treated by stent-assisted angioplasty. Vascular stenosis rate and NIHSS score before treatment and after 12 months of discharge,incidence of vascular occlusion,new cerebral infarction and TIA after 12 months of discharge were compared between the two groups,and the safety of stent-assisted angioplasty was observed. Results No statistically significant differences of vascular stenosis rate or NIHSS score was found between the two groups before treatment ( P >0. 05 );after 12 months of discharge,vascular stenosis rate,NIHSS score,incidence of vascular occlusion,new cerebral infarction and TIA of observation group were statistically significantly lower than those of control group ( P<0. 05 ). The surgical successful rate of observation group was 97. 9%,and no one of observation occurred severe perioperative complications,but the restenosis rate of vertebral artery origin was 27. 1%. Conclusion Stent-assisted angioplasty has better clinical effect on severe VAOS,can effectively relieve the vascular stenosis,improve the neurological function,is with high safety,but the restenosis rate is high.
