脑供血动脉支架患者围手术期并发症的临床分析及对策  

作　　者：郑永强[1] 秦碧勇[1] 刘南暖[1] 邓晓玲[1] 汪健[1] 王成谋[1] 

机构地区：[1]湖北医药学院附属十堰市人民医院神经内科

出　　处：《浙江临床医学》2015年第7期1062-1064,共3页Zhejiang Clinical Medical Journal

基　　金：湖北省十堰市科学技术研究与开发项目（ZD201202215Y33）

摘　　要：目的分析脑血管支架手术相关并发症发生的原因并寻找对策。方法选择脑供血动脉支架置入术患者224例（248枚）。分析围手术期相关并发症的发生情况。结果224例脑血管支架患者出现并发症19例（8．2％）。其中死亡4例（1．8％）、轻度残疾2例（0．8％）、无后遗症13例（5．8％）。颅外动脉支架14枚，颅内动脉支架7枚。颅外支架并发症远高于颅内支架；颅内支架（42．8％）严重并发症高于颅外支架（7．1％）。合并糖尿病或高血压是支架术后并发症的危险因素。前4年和后4年的手术并发症发病率分别为11．7％、5．38％，差异有统计学意义。结论锁骨下动脉支架、椎动脉起始部支架是相对安全的手术；颅内动脉支架、颈内动脉起始部支架风险性较高。严格的手术适应证及禁忌证、临床医师的操作技术与经验是影响脑动脉支架并发症发生的重要因素。Objective To analyze the causes of cerebral vascular stent surgery-related complications, find countermeasures, as far as possible to avoid it in the future stand postoperative recurrence. Methods 224 patients underwent 248 cerebral artery stenting. Analysis of the incidence of perioperative surgery-related complications. Results 224 patients with cerebral vascular stent complications 19 cases （ 8.2% ） . 19 cases of patients with complications prognosis： died 4 cases （ 1.8% ） , mild disability 2 cases （ 0.8% ） , without sequelae 13 cases （ 5.8% ） .Extracranial artery stent 14 cases, seven cases of intracranial stents, lntracranial complications of stent were much higher than extracranial stent; intracranial stents （ 42.8%, 3/7 ） were higher than the extraeranial stent serious complications （ 7.1%, 1/14 ） . Diabetes and hypertension were both risk factors for stem complications. The first four years and four years after the incidence of surgical complications was 11.7% （ 11/94 ） and 5.38% （ 7/130 ） were statistically significant. Conclusions （1） The subclavian artery stents and the beginning part of the vertebral artery stem are relatively safe procedures; intracranial artery stenting and carotid artery bracket are of higher risk. （ 2 ） strict surgical indications and contraindications, surgeon＇ s technique and experience are important risk factors for compilations.

关 键 词：脑 动脉狭窄 支架置入 并发症 

分 类 号：R734.5[医药卫生—肿瘤]