经皮血管内成形及支架置入术治疗伴重度颈动脉狭窄脑梗死的短期疗效评价  

Short-term efficacy of percutaneous vascular forming and stenting in patients with severe stenosis combined with cerebral infarction

作　　者：刘悦[1] 范承哲[1] 王力[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,北京100029

出　　处：《中华神经医学杂志》2017年第7期688-691,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨经皮血管内成形及支架置入术治疗伴重度颈动脉狭窄脑梗死患者的短期临床疗效。方法选择首都医科大学附属北京安贞医院神经内科自2011年1月至2014年1月收治的74例伴重度颈动脉狭窄脑梗死患者，根据治疗方式的不同将患者分为手术组（采取经皮血管内成形及支架置入术治疗，37例）与非手术组（采取常规药物治疗，37例）。分别在患者出院后1个月、3个月、6个月时对其进行随访，记录其在随访期间的情况．主要包括是否再次发生脑梗死及美国国立卫生研究院卒中量表（NIHSS）和简易精神状态量表（MMSE）评分。结果治疗前2组患者颈动脉狭窄范围、NIHSS评分、MMSE评分等差异无统计学意义（P〉0．05）。治疗后．手术组患者颈动脉狭窄范围为（32．35±4．15）％，显著低于非手术组的（72．32±7．721％，差异有统计学意义（P〈O．05）。出院后3个月，手术组患者NIHSS评分[（7．05±1．35）分]明显低于非手术组患者[（8．89±1．76）分]，差异有统计学意义（P〈0．05）。出院后1个月，手术组患者MMSE评分[（22．24±2．74）分]明显高于非手术组患者[（20．29±3．15）分]，差异有统计学意义（P〈0．05）。结论经皮血管内成形及支架置入术治疗伴重度颈动脉狭窄脑梗死的短期效果较好，优于药物治疗。Objective To explore the clinical efficacy of percutaneous vascular forming and stenting in patients with severe stenosis combined with cerebral infarction. Methods The clinical data of 74 patients with severe carotid stenosis combined with cerebral infarction, admitted to our hospital from January 2011 to January 2014, were analyzed; and according to the treatment methods, all patients were divided into operation group （percutaneous angioplasty and stenting, n=37） and non-operation group （conventional therapy, n=37）. Follow-up was performed one, 3 and 6 months after discharge, and the prognoses of these patients were evaluated with NIHSS and mini-mental state examination （MMSE）. Results Before treatment, the rate of carotid artery stenosis, NIHSS scores and MMSE scores in the two groups showed no significant differences （P〉0.05）. After treatment, stenosis rate of the operation group （[32.35±4.15]%） was significantly lower than that in the non-operation group （[72.32±7.721%, P〈0.05）. One month after treatment, the MMSE scores in the operation group （22.24±2.74） were significantly higher than those in the non-operation group （20.29±3.15, P〈0.05）. Three months after treatment, the NIHSS scores in the operation group （7.05±1.35） were significantly lower than those in the non-operation group （8.89±1.76, P〈0.05）. Conclusion Percutaneous vascular forming and stenting can help to achieve favorable outcome in patients with severe stenosis combined with cerebral infarction, which achieves better effect than conventional therapy.

关 键 词：脑梗死 经皮血管内成形 支架置入术 颈动脉狭窄 

分 类 号：R743.31[医药卫生—神经病学与精神病学]