血管特点对颈动脉狭窄老年患者支架置入手术效果影响的彩色多普勒超声影像研究  

Study of color doppler ultrasonography on the effect of vascular characteristics on stent implantation in elderly patients with carotid stenosis

作　　者：陶娜 Tao Na(Ultrasonic Diagnosis Department of Xinyang Central Hospital,Xinyang 464000)

机构地区：[1]河南省信阳市中心医院超声诊断科

出　　处：《中国现代医药杂志》2019年第11期37-41,共5页Modern Medicine Journal of China

摘　　要：目的运用彩色多普勒超声影像探究血管特点对颈动脉狭窄老年患者支架植入手术效果的影响。方法分别于术前1个月和术后1周内对患者进行CDFI检查,根据术后DSA影像及CDFI的结果判定残余狭窄率,记录并分析患者血管特点,包括患者颈动脉病变的管腔结构以及动脉粥样硬化斑块特征对残余狭窄发生率的影响。同时,记录并分析患者接受CAS置入术两周后血管内径及血流动力学参数。结果CAS术后残余狭窄共发生18例,残余狭窄发生率为21.95%;CDFI的检测结果显示,相较于无残余狭窄组,残余狭窄组颈动脉内径明显减小(P<0.05),PSV和EDV明显升高(P<0.05)。两组患者的PSV和EDV差异均无统计学意义(P>0.05)。在血管狭窄结构特点对术后残余狭窄影响方面,不均质回声斑块患者残余发生枚数为30枚,占66.67%;均质回声斑块残余发生枚数为16枚,占43.24%;不均质回声斑块患者残余狭窄发生率明显高于均质回声斑块的患者。而在均质回声斑块病例中的强回声斑块患者的残余狭窄发生率为57.14%,高于等回声和低回声斑块组,但差异无统计学意义(P>0.05);在不均质回声斑块患者记录数值方面,斑块表面钙化患者残余狭窄率为56.25%,远高于基底部钙化和非钙化斑块组患者(P<0.05)。另一方面,不规则形态斑块患者的残余狭窄发生率为62.22%,高于规则形态斑块患者(35.14%)(P<0.05)。单因素分析比较:高血压、表面钙化斑块、不规则斑块在有无术后残余患者中分布占比有显著性差异(P<0.05)。多因素Logistic回归分析结果显示,表面钙化斑块和不规则斑块是影响CAS置入手术术后残余狭窄的重要因素(P<0.05)。结论颈动脉狭窄血管的结构特点是影响老年患者CAS术后支架内发生残余狭窄的重要原因。研究结果显示,均质回声斑块患者残余狭窄发生率远远低于不均质回声斑块患者。表面钙化斑块也是造成CAS术后残余狭窄率�Objective To explore the effect of vascular characteristics for elderly carotid stenosis patients accepted stent implantation by color doppler ultrasourd imaging.Methods CDFI was performed one month before operation and one week after operation.Residual stenosis rate was determined according to DSA imaging and CDFI node,and blood vessel characteristics were recorded and analyzed including bureaucratic structure of carotid artery stenosis and the influence of atherosclerotic plaque characteristics to the incidence of residual stenosis.At the same time,the blood vessel diameter and hemodynamic parameters were recorded and analyzed after two weeks of CAS implantation.Results There were 18 cases of residual stenosis after operation,and the incidence of residual stenosis was 21.95%.The results of CDFI showed that compared with no residual stenosis group,carotid diameter artery stent diameter significantly decreased,PSV and EDV increased(P<0.05).There was no significant difference in the value of PSV and EDV between the two groups(P>0.05).In the aspect of structural characteristics of vascular stenosis postoperative residual stenosis,heterogeneous echo patients was 30 cases,accounting for 66.67%;homogeneous echo was 16 cases,accounting for 43.24%;heterogeneous echo had a significantly higher incidence than homogeneous echo.The stenosis rate of strong echo in homogeneous echo was 57.14%,which was higher than low echo and equal echo;in the heterogeneous echo were recorded numerical,calcified plaque surface residual stenosis in patients with rate of 56.25%,far higher than the basal calcified and non calcified plaque group.On the other hand,the incidence of residual stenosis in irregular plaque patients was 62.22%,which was also higher than the incidence of residual stenosis in 35.14%of regular plaque patients.Univariate analysis and comparison:hypertansion,surface calcified plaque,and irregular plaque were significantly different in the proportion of patients with or withont postoperative residual plaque(P<0.05).Multivari

关 键 词：血管特点 颈动脉狭窄 支架置入手术 彩色多普勒超声影像 

分 类 号：R54[医药卫生—心血管疾病]