颈动脉支架置入术并发高灌注综合征的研究  

Study of carotid artery stenting with high perfusion syndrome

作　　者：符晓艳[1] 王羚入[1] 江礼[1] 李囿佑 喻刚连 周华东[1] FU Xiao-yan;WANG Ling-ru;JIANG Li;LI You-you;YU Gang-lian;ZHOU Hua-dong(Department of Neurology,Institute of Combat Surgery,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《中华全科医学》2020年第2期322-324,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(8157051852)。

摘　　要：目的研究探讨颈动脉支架置入术高灌注综合征的发生与年龄、收缩压和血管狭窄程度的相关性。方法选取2011年1月-2015年12月在陆军军医大学大坪医院野战外科研究所神经内科行颈动脉支架置入术的257例患者为研究对象,术前行经颅多普勒超声检查了解患者脑血流基本情况,术后1、12、24 h再行床旁TCD检查和术前的检查结果进行对比,根据TCD检查结果将257例患者分为CHS组13例为研究组和无CHS组244例为对照组,分析颈动脉支架置入术后高灌注综合征的发生与年龄、收缩压和血管狭窄程度的相关性。结果颈动脉支架置入术后高灌注综合征的发生率为5.1%(13/257),随着年龄的增加、收缩压的增高、血管狭窄程度的增大,CHS的发生率逐渐增高(χ^2=17.973、24.357、23.488,均P<0.001)。结论高灌注综合征是颈动脉支架置入术后少见但严重的并发症,高龄、收缩压≥170 mm Hg(1 mm Hg=0.133 kPa)、血管狭窄程度≥90%的患者更易发生。临床工作中应密切观察患者的血压变化情况,严格控制好血压,特别是高龄、血管高度狭窄的患者,是预防和减少高灌注综合征发生的护理要点。Objective To investigate the association of cerebral hyperperfusion syndrome(CHS) with age and vascular stenosis severity in patients with carotid artery stenting. Methods From January 2011 to December 2015, 257 patients with carotid artery stenting were selected as the subjects. Before operation, transcranial Doppler ultrasound was used to investigate the basic blood flow of the patients, the postoperative 1, 12, 24 h and the bedside TCD examination were compared with the preoperative examination results, According to the results of TCD examination, 257 patients were divided into CHS group(13 cases) and control group(244 cases) without CHS group, to analyze the correlation between the incidence of high perfusion syndrome after carotid artery stenting and age, systolic blood pressure and vascular stenosis. Results The incidence of CHS was 5.1%(13/257) in patients with carotid artery stenting, with the increase of age, systolic blood pressure and vascular stenosis, the incidence of CHS increased gradually(χ^2=17.973, 24.357, 23.488, all P<0.001). Conclusion High perfusion syndrome is a rare but serious complication after carotid artery stenting. The patients who are older, more than 170 mm Hg(1 mm Hg=0.133 kPa), and the degree of stenosis more than 90% are more likely to occur. In clinical work, the change of blood pressure should be closely observed and strict control of blood pressure, especially in elderly patients with stenosis of blood vessels, is the nursing key to prevent and reduce the occurrence of high perfusion syndrome.

关 键 词：颈动脉狭窄 介入治疗 高灌注综合征 

分 类 号：R543.4[医药卫生—心血管疾病] R741.05[医药卫生—内科学]