支架置入与药物治疗椎动脉起始部狭窄的疗效观察  

Clinical observation of the stenting and medication for vertebral artery origin stenosis

作　　者：陈丹丹[1] 王秀 

机构地区：[1]天津中医药大学第一附属医院脑病介入科,300193 [2]天津市武清区中医医院

出　　处：《天津医药》2018年第2期187-190,共4页Tianjin Medical Journal

摘　　要：目的对比支架置入与药物治疗椎动脉起始部狭窄的疗效。方法将76例椎动脉起始部狭窄患者分为支架组(40例)和药物组(36例),分别给予支架置入及药物治疗,观察支架组患者围手术期(术后30 d)并发症发生率及再狭窄率。记录2组在3个月、6个月、12个月时后循环缺血症状再发情况以及12个月时2组患者病变血管狭窄程度的变化。结果支架组40例患者共置入支架43枚,手术成功率100%,围手术期并发症发生率12.5%;支架组患者术后即刻血管狭窄程度从(80.36±6.42)%降至(18.21±5.92)%;12个月后支架组血管狭窄率为(22.82±9.80)%,与术后即刻比较差异无统计学意义(P>0.05),而药物组治疗前、后的血管狭窄率分别为(79.98±5.76)%、(83.42±9.53)%,差异无统计学意义(P>0.05);治疗前支架组血管狭窄率与药物组差异无统计学意义(P>0.05),治疗12个月后明显低于药物组(P<0.05);随访期间支架组、药物组分别有4例(10%)、10例(27.8%)发生后循环缺血事件,支架组明显低于药物组(P<0.05)。结论支架置入治疗椎动脉起始部狭窄安全、有效,其预防后循环缺血事件的疗效优于单纯药物治疗。Objective To compare the efficacy between stenting and medication in patients with vertebral artery originstenosis. Methods Seventy-six patients with vertebral artery origin stenosis were divided into stent group(n=40) andmedication group(n=36). The incidences of complications in the perioperative period(30 days after surgery), and the rates ofcerebral ischemic events after 3 months, 6 months and 12 months were recorded in two groups. The changes of vascularstenosis after 12 months were also observed in two groups. Results Forty-three stents were implanted in 40 patients. Theoperation success rate was 100%, and perioperative complication rate was 12.5%. The vascular stenosis rate was decreasedfrom(80.36±6.42) % to(18.21±5.92)% after operation in the stent group, and increased to(22.82± 9.80)% after 12 months.There was no significant difference in the vascular stenosis rate between postoperative instant and 12 months after operation(P>0.05). The vascular stenosis rate was increased from(79.98±5.76)% to(83.42±9.53)% after treatment in the medicationgroup but no statistical significance in the difference(P>0.05). There was no significant difference in the vascular stenosisrate between the stent group and the medication group before treatment, but which was significantly lower in the stent groupthan that of the medication group after 12-month treatment(P<0.05). There were four cases(10%) of ischemic events in thestent group and 10 cases(27.8%) in the medication group during the follow-up period. The ischemic events weresignificantly lower in the stent group than those of the medication group(P<0.05). Conclusion Stenting is safe andeffective for patients with vertebral artery origin stenosis, which is better than medication for preventing the occurrence of theposterior circulation ischemic events.

关 键 词：椎底动脉供血不足 药物疗法 椎动脉起始部狭窄 支架置入 血管内治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]