锁骨下动脉盗血综合征患者的介入治疗  

Subclavian artery steal syndrome patients with interventional therapy

作　　者：王宫[1] 卫飞[1] 刘娟[1] 

机构地区：[1]第三军医大学第二附属医院神经内科,重庆400037

出　　处：《局解手术学杂志》2017年第7期522-526,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨锁骨下动脉盗血综合征(SSS)患者介入治疗的可行性与效果。方法回顾性分析我院神经内科2014年10月至2016年3月收治的35例锁骨下动脉盗血综合征患者的临床资料。所有患者均行经皮血管成型并支架植入术治疗,利用数字减影血管造影(DSA)测量血管狭窄程度、水银血压计检查双上肢收缩压差并比较患者手术前后临床表现,观察患者临床表现、血流情况和血管狭窄程度。结果所有患者均成功行经皮血管成型并支架植入术治疗,7例血管狭窄严重患者支架植入前先行经皮血管内球囊扩张术;DSA测得动脉平均狭窄程度由术前(74.73±10.42)%降至术后即刻(8.60±3.16)%,狭窄程度明显好转,差异具有统计学意义(P<0.01);水银血压计显示双上肢收缩压差由术前(44.43±10.12)mm Hg降至术后2~7 d(10.09±4.80)mm Hg,收缩压差改善显著,差异具有统计学意义(P<0.01);随访1~12个月,34例支架形态完好,未见新的狭窄形成,1例在术后7个月出现支架内狭窄,后经再次手术后恢复;28例症状显著好转或消失,5例部分缓解,2例复发,未发生血栓形成及严重梗塞等并发症。结论经皮血管成型并支架植入术对于锁骨下动脉盗血综合征患者疗效稳定、手术成功率高且短期复发率低,改善血管狭窄、双上肢收缩压差及临床表现效果明显。Objective To explore the feasibility and effect of intervention therapy for patients subclavian steal syndrome. Methods The data of 35 patients with subclavian artery steal syndrome in neurology department of our hospital from October 2014 to March 2016 were retrospectively analyzed. All patients treated with pecutaneous transtuminl angioplasty and stenting. The degree of vascular stenosis was meas- ured by digital subtraction angiography, the inter-arm blood pressure was tested by mercury sphygmomanometer. And the clinical manifesta- tions before and after surgery were compared. All patients were followed up for 1 to 12 months ,the clinical manifestations ,blood flow and vas- cular stenosis degree in patients were observed. Results All patients were finished pecutaneous transtuminl angioplasty and stenting success- fully ,7 patients with serious vascular stenosis treated with percutaneous intravascular balloon dilatation at first. The average artery stenosis be- fore operation was （74.73 -± 10.42 ）%, while it decreased to （8.60 ± 3.16 ）% after surgery, which were measured by DSA, the difference was significant（P 〈0.01 ）. The result from mercury sphygmomanometer showed that the inter-arm blood pressure from preoperative （44.43 ± 10.12 ） mmHg to postoperative （ 10.09 ± 4.80） mmHg （ 2 - 7 days） , systolic blood pressure differential minified significantly, the difference was significant（ P 〈 0.01 ）. All patients were followed up for 1 to 12 months, support forms of 34 cases were in good conditions without new narrow, 1 case appeared narrow in postoperative 7 months, then recovered after reoperation ; symptoms of 28 cases significantly improved or disappeared,5 cases partly alleviated, 2 cases had recurrence, no serious complications such as thrombosis and severe infarction occurred. Conclusion The pecutaneous transtuminl angioplasty and stenting is stable,high successful and low short-term recurrence rate for subclavian steal syndrome,which is good to alleviate vascular stenosis,

关 键 词：锁骨下动脉盗血综合征 锁骨下动脉狭窄 介入治疗 支架植入 

分 类 号：R459.9[医药卫生—治疗学]