老年人颈动脉狭窄支架置入术的血流动力学紊乱研究  

Periprocedural hemodynamic instability for carotid angioplasty and stenting in elderly patients with carotid stenosis

作　　者：王利军[1] 王大明[2] 刘加春[2] 陆军[2] 祁鹏[2] 姜雪丽[2] 翟乐乐[2] 

机构地区：[1]中国协和医科大学,北京100730 [2]卫生部北京医院神经外科,北京100730

出　　处：《中国医学影像技术》2007年第5期784-787,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金项目(30571915);卫生部临床学科重点项目(卫规财发[2001]321号)

摘　　要：目的探讨老年人颈动脉狭窄支架置入术血流动力学紊乱的发生、预防及处理方法。方法回顾性分析88例60岁以上颈动脉狭窄患者支架置入过程中发生的血流动力学紊乱病例,分析其临床和影像学特点。结果88例患者中血流动力学紊乱发生率为33%;70岁以上患者低血压和心动过缓发生率明显高于70岁以下者,狭窄与颈动脉分叉部距离≤10mm者高于>10mm者,分叉部伴有钙化灶者高于无钙化灶者(P<0.05)。结论血流动力学紊乱是老年人颈动脉狭窄支架置入术中和术后常见的并发症,高龄、狭窄位置和分叉部钙化是其发生的相关因素,正确的围手术期处理可减少相关并发症的发生。Objective To study the frequency, prophylactic and treatment measures of hemodynamic instability in elderly patients who underwent carotid angioplasty and stenting （CAS）. Methods All cases of hemodynamic instability were reviewed in a series of 88 eldly patients who underwent CAS, clinical characteristics and angiogram features were analyzed. Resalts The frequency of hemodynamic instability in our patient series was 33% in 88 elderly patients. The incidence of hypotension and bradycardia was significantly higher in patients who was over 70 years old, and it was higher in the patients with carotid stenosis that the distance from carotid bifurcation to stenotic lesion ≤10 mm than the distance 〉10 mm; it was also higher in the patients with calcification at carotid bifurcation （P〈0.05）. Conclusion Periprocedural hemodynamic instabili ty for CAS was the most frequent complication in elderly patients. Elderly patients, the site of stenotic lesion and calcifica tion at carotid bifurcation were related to hemodynamic instability. Properly treatment might decrease the incidence of corn plications duo to hemodynamic instability.

关 键 词：老年人 支架 颈动脉狭窄 血流动力学 

分 类 号：R543.4[医药卫生—心血管疾病] R815[医药卫生—内科学]