脑血管支架置入后的并发症及其预防  

Prevention of complications following cerebrovascular stent implantation

作　　者：官昌伦[1] 石国霰[1] 李琴[1] 罗永梅[1] 曾尤超[1] 

机构地区：[1]遵义医学院第三附属医院神经内科一病区,贵州省遵义市563002

出　　处：《中国组织工程研究与临床康复》2010年第9期1681-1684,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:分析脑血管支架置入后并发症的原因,发生机制及其预防方式。方法:应用计算机检索Medline database(1989/2009)和中国期刊全文数据库(CNKI:1989/2009),由第一作者按纳入和排除标准,对文献进行筛选,资料收集和质量评价。从脑血管支架置入的治疗进展,脑血管支架的种类及生物相容性,支架置入后并发症的发生及预防3方面进行描述和整理,并对并发症的发生进行临床验证。结果:脑血管支架置入后的并发症主要有颈动脉窦反应、高灌注综合征、脑血管痉挛、穿刺部位出血、支架处血栓形成、其他部位再狭窄及脑缺血等。支架置入后并发症的发生虽然很难完全杜绝,但应尽量避免,要做到正解选择支架置入病例,提高操作者的熟练程度和纠正不良操作习惯,提高术者对并发症的认识和重视程度,严格围手术期的管理,对出现的并发症要及时正确处理避免产生严重后果。在各种脑血管支架中,金属支架生物相容性较差,聚合物支架、涂层支架和药物支架生物相容性均好于金属支架,能有效的预防支架置入后的再狭窄。结论:脑血管支架置入治疗可作为脑血管病的主要治疗方法之一;脑血管支架中的药物支架,聚合物支架的生物相容性较好;在治疗过程中只要进行充足的置入前准备,正确的操作与围绕手术期管理,则脑血管支架置入后的并发症是可防可治疗的。OBJECTIVE：To explore the reasons,occurrence mechanisms,as well as prevention methods for complications following cerebrovascular stent implantation.METHODS：A computer-based online search was performed by the first author.The databases of Medline and CNKI were searched with year＇s limitation of 1989-2009.According to the inclusive and exclusive criteria,the documents were screened,collected and evaluated from the following aspects：treating progress of cerebrovascular stent implantation;category and biocompatibility of cerebrovascular stent;as well as occurrence and prevention methods for complication following cerebrovascular stent implantation.RESULTS：A series of complications,such as carotid sinus response,hyper-perfusion syndrome,cerebral angio spasm,bleeding at puncture locus,thrombosis,restenosis,as well as cerebral ischemia,would occur following cerebrovascular stent implantation.The complications were difficult to eliminate,but should be avoided by selecting correct implanting cases,elevating operator＇s proficiency,enhancing understanding of complications,obeying perioperative management,as well as correctly and in-time treatment.Polymer stent,coating stent,and drug eluting stent presented superior biocompatibility to metal stent,which could prevent restenosis following implantation.CONCLUSION：Cerebrovascular stent implantation is one of the main treatments for cerebrovascular disease.Polymer stent,coating stent,and drug eluting stent exhibit excellent biocompatibility.The complications associate to stent implantation are preventable and remediable via sufficient preoperatively preparation,exactly operation and perioperative management.

关 键 词：脑血管病 支架 治疗 并发症 生物相容性 康复治疗 

分 类 号：R772.2[医药卫生—眼科]