症状性慢性颈动脉闭塞的临床研究  

Clinical study of symptomatic chronic carotid artery occlusion

作　　者：梁春阳[1] 徐如祥[1] 张强[1] 沈春森[1] 罗永春[1] 毛锦龙[1] 马尚[1] 杨阳[1] 

机构地区：[1]北京军区总医院附属八一脑科医院神经外科,100700

出　　处：《中国微侵袭神经外科杂志》2015年第9期385-388,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金项目(编号:30940075)

摘　　要：目的探讨症状性慢性颈动脉闭塞病人的临床特征、血管内治疗方法及影响预后的因素,以提高诊疗水平。方法回顾性分析20例症状性慢性颈动脉闭塞病人的临床资料,均采用血管内再开通手术。术后疗效采用美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)及3个月后改良Rankin量表(modified rankin scale,m RS)进行评估。结果再开通13例,余7例未再开通。再开通组术后7 d NIHSS评分及3个月后m RS评分均低于未再开通组(P<0.05),且两组术后并发症无统计学差异(P>0.05)。Logistic回归分析显示血管再开通(OR=0.46,P=0.006)及术前NIHSS评分(OR=8.86,P=0.035)与术后3个月m RS评分相关。结论血管内治疗对于有症状的慢性颈动脉闭塞病人较安全,并且可以降低预后残障程度。Objective To explore the clinical characteristics, endovascular treatment and factors influencing the prognosis of the symptomatic chronic carotid artery occlusion for raising the level of diagnose and treatment. Methods Clinical data of 20 patients with the symptomatic chronic carotid artery occlusion were analyzed retrospectively, who received endovascular treatment. The therapeutic efficacy was evaluated by national institutes of health stroke scale（NIHSS） and modified rankin scale（m RS） 3 months after surgery.Results Recanalization was achieved in 13 patients but did not achieve in 7. The NIHSS score 7 d after surgery and m RS score 3 months after surgery in recanalization group were lower than the un-recanalization group（P〈0.05）, but there was no difference in complications between the two groups（P 〉0.05）. Multivariable Logistic regression analysis revealed recanalization（OR = 0.46, P = 0.006） and preoperative NIHSS score（OR = 8.86, P = 0.035） were related to m RS scores 3 months after surgery. Conclusion Endovascular treatment is safe for the symptomatic chronic carotid artery occlusion and can reduce disability degree in prognosis.

关 键 词：颈动脉闭塞 症状性 慢性 血管内治疗 再通 

分 类 号：R651.1[医药卫生—外科学]