后循环动脉狭窄支架植入前后血流动力学变化的初步研究  

Preliminary study of hemodynamics change after stent implantation for posterior circulation artery stenosis

作　　者：陈茂华 陆川 孙军 

机构地区：[1]温州市中心医院神经外科,325000

出　　处：《中国微侵袭神经外科杂志》2013年第9期396-398,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：浙江省公益性技术应用研究计划项目(编号:2010C33015);浙江省市共建医药卫生专项基金计划(编号:2010SSA004);温州市科技计划项目(编号:Y20130104)

摘　　要：目的探讨症状性椎-基底动脉狭窄内支架成形术前后脑血流动力学变化。方法回顾性分析38例症状性椎-基底动脉狭窄病人的临床资料,其中中度狭窄32例,重度狭窄6例。病人均行血管内支架成形术,手术前后行经颅彩色多普勒(TCD)及脑CT灌注成像(CTP)检查,测量狭窄处血流速度峰值及平均脑血容量(CBV)、平均脑血流量(CBF)、平均通过时间(MTT)。结果支架成形术后,动脉狭窄处血流速度峰值由术前的(226±27)cm/s降至(135±18)cm/s,差异有统计学意义(P<0.01)。直接供血区术后MTT较术前明显降低(P<0.01),CBF较术前明显增高(P<0.05),CBV较术前无明显改变(P>0.05)。结论 TCD联合CTP可评估症状性椎-基底动脉狭窄内支架成形术后脑灌注改善情况。Objective To discuss the hemodynamics change after stent-assisted angioplasty for symptomatic vertebrobasilar artery stenosis. Methods Clinical data of 38 patients with symptomatic vertebrobasilar artery stenosis were analyzed retrospectively, including moderate stenosis in 32 patients and severe stenosis in 6. The stent-assisted angioplasty was performed in all the patients. Transcranial Doppier （TCD） and CT perfusion （CTP） were performed before and after the surgery, and the indexes such as peak blood velocity in vascular stenosis, cerebral blood volume （CBV）, cerebral blood flow （CBF） and transit time （MTT） were detected. Results After stent-assisted angioplasty, peak blood velocity in artery stenosis declined significantly from 226 ±27 cm/s to 135 ± 18 cm/s （P 〈 0.01）, Compared with the preoperative indexes, the postoperative MTT in the direct blood supply area obviously decreased （P 〈 0.01）, postoperative CBF obviously increased （P 〈 0.05）. Conclusion TCD and CTP can be used to evaluate the improvement of cerebral perfusion after stent-assisted angioplasty in patients with symptomatic vertebrobasilar artery stenosis.

关 键 词：椎底动脉供血不足 超声检查 多普勒 经颅 CT灌注成像 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]