小球囊预扩支架成形术治疗颈内动脉起始部重度狭窄的疗效观察  

Small Balloon Pre Dilation Stent Angioplasty in the Treatment of Stenosis in the Internal Carotid

作　　者：曲桂艳[1] 董志领[1] 韩丽丽[1] 史方堃[1] 刘红梅[1] 

机构地区：[1]河北省沧州市中心医院神经内一科,061001

出　　处：《中国全科医学》2014年第6期689-691,共3页Chinese General Practice

摘　　要：目的 观察颈内动脉重度狭窄患者采用小球囊预扩支架成形术治疗的疗效.方法 选取2009年6月-2012年6月沧州市中心医院收治的有症状的颈内动脉起始部重度狭窄（狭窄率≥80%）患者120例,根据治疗不同分为支架组80例和药物组40例.支架组患者均采用小球囊预扩技术后放置保护伞,观察0.5～1.0 h,采用大球囊扩张,放置支架;药物组按照脑卒中治疗指南,根据患者的病情采用个体化治疗,采用静脉或动脉溶栓.记录两组治疗前及治疗后1年血管狭窄率、神经功能缺损评分（NIHSS）,治疗后1年内并发症发生率.结果 治疗前支架组和药物组血管狭窄率和NIHSS比较,差异均无统计学意义（P＞0.05）;治疗后1年药物组血管狭窄率、NIHSS及血管闭塞、再狭窄、短暂性脑缺血发作、脑梗死发生率较支架组均增高（P＜0.05）.结论 采用小球囊预扩支架成形术治疗颈内动脉起始部重度狭窄是安全、有效的,颈内动脉起始部重度狭窄有症状的患者应尽早地采用支架治疗.Objective To observe the curative effect of small balloon pre dilation stent angioplasty in the treatment of the patients with severe stenosis in the internal carotid. Methods 120 patients with stenosis in carotid artery （ stenosis rate ≥ 80% ） admitted to Cangzhou Central Hospital from June 2009 to June 2012 were divided into stent group （80 cases） and drug group （40 cases） . The stent group was placed with umbrella by using small balloon pre dilation technique. After observing for 0. 5 to one hour, the stent group was placed with stent by using big balloon dilation technique. The drug group was given individu- alized treatment of intravenous and intra - arterial thrombolysis according to the treatment principle of stroke. The vascular resteno- sis rate and NIHSS were recorded in the two groups before and one year after treatment, and the incidence of complication was al- so recorded within one year after treatment. Results Before treatment, the incidence of stenosis and NIHSS between the two groups showed no statistically significant difference （P 〉 0. 05 ） . One year after treatment, the incidence of vascular stenosis, NIHSS, incidences of vascular occlusion, restenosis, transient cerebral ischemia and cerebral infarction were higher in the drug ,group compared with the stent group （P 〈 0. 05） . Conclusion Small balloon pre dilation technique is safe and effective in the treatment of internal carotid artery stenosis. Patients with severe stenosis in internal carotid artery should adopt the treatment as early as possible.

关 键 词：颈内动脉 颈动脉狭窄 血管成形术 药物洗脱支架 

分 类 号：R543.5[医药卫生—心血管疾病]