颈动脉狭窄支架成形术后发生持续性低血压的危险因素分析  

Analysis of Risk Factors Related to Prolonged Hypotension after Carotid Stent-supported Angioplasty in 32 Patients with Symptomatic Carotid Artery Senosis

作　　者：朱青峰[1] 王国芳[1] 王千[1] 边世春[1] 禹书宝[1] 王风伟[1] 

机构地区：[1]中国人民解放军第264医院神经外科,山西太原030001

出　　处：《中国临床神经外科杂志》2008年第7期393-396,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颈动脉狭窄支架成形术后发生持续性低血压的危险因素。方法2006年7月至2008年1月,我科应用颈动脉狭窄支架成形术治疗颈动脉狭窄32例。采用单因素及Logistic多因素回归分析术后发生持续性低血压的危险因素。结果32例患者中,术后5例出现短暂性低血压(持续时间<6h),15例出现持续性低血压(持续时间>6h)。单因素分析结果提示,术前有低血压病史、颈动脉狭窄程度>70%、血管狭窄长度>15mm、支架置入前使用球囊预扩、支架直径稍大于颈动脉直径、手术操作时间超过1h与术后发生持续性低血压有关。多因素分析结果提示,术前有低血压病史、血管狭窄长度>15mm、支架直径稍大于颈动脉直径、手术操作时间超过1h为术后发生持续性低血压的危险因素。结论术前有低血压病史、血管狭窄长度>15mm、用直径稍大于颈动脉直径的支架行颈动脉成形的及介入治疗操作时间较长的患者,术后容易发生持续性低血压。Objective To analyze the risk factors related to prolonged hypotension after carotid stent-supported angioplasty in the patients with symptomatic carotid artery senosis. Methods Thirty-two patients with symptomatic carotid artery stenosis, who were treated from July, 2006 to January, 2008, were divided into normal blood pressure, transient hypotension （lasting less than 6 hours）, and prolonged hypotension （lasting more than 6 hours） groups. The risk factors related to the prolonged hypotension were analyzed by the Logistic regression. Results Of 32 patients, 5 had transient hypotension, 15 prolonged hypotension and 12 normal blood pressure after the carotid stent-supported angioplasty. Univariate analysis showed that the factors including the hypotension before the angioplasty, stenosis 〉70% of carotid cavity, the length of the carotid stenosis 〉15 mm, dilatation of carotid artery by balloon before the angioplasty, the diameter of stents 〉 diameter of the carotid artery, and the procedure of angioplasty lasting more than 1 hour were related with the prolonged hypotension. Multivariate analysis showed that the hypotension before the angioplasty, the length of the carotid stenosis 〉15 mm, dilatation of carotid artery by balloon before the angioplasty, the diameter of stents 〉 diameter of the carotid artery, and the procedure of angioplasty lasting more than 1 hour were the independent risk factors related to prolonged hypotension after angioplasty. Conclusions The prolonged hypotension is easily produced after carotid stent-supported angioplasty in the patients with hypotension before the angioplasty or the length of the carotid stenosis 〉15 ram and in the patients who underwent dilation of carotid artery before the angioplasty, or the procedure of angioplasty lasting more than 1 hour and received implantation of stent having a diameter of bigger than that of the carotid artery.

关 键 词：血管内支架成形术 颈动脉狭窄 低血压 危险因素 

分 类 号：R743.31[医药卫生—神经病学与精神病学] R743.9[医药卫生—临床医学]