颈动脉支架置入术后严重并发症患者早期应用连续性肾脏替代疗法一例  

Early application of continuous renal replacement therapy in a patient with severe complications after carotid artery stenting

作　　者：唐建红 赵娜娜 李俊毅 葛永纯 张方 卢红腾 刘锐 樊新颖 郭芮兵 朱武生 Tang Jianhong;Zhao Nana;Li Junyi;Ge Yongchun;Zhang Fang;Lu Hongteng;Liu Rui;Fan Xinying;Guo Ruibing;Zhu Wusheng(Department of Neurology,Eastern District General Hospital,Nanjing 210002,China;不详)

机构地区：[1]东部战区总医院神经内科,南京210002 [2]浙江省兰溪市人民医院神经内科,321100 [3]东部战区总医院国家肾脏疾病临床医学研究中心 [4]东部战区总医院呼吸科与重症医学科 [5]厦门市第三医院神经内科

出　　处：《中国脑血管病杂志》2021年第1期53-56,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：江苏省社会发展-临床前沿技术项目(BE2016748)。

摘　　要：笔者回顾性分析1例左锁骨下动脉和左颈内动脉重度狭窄行颈动脉支架置入术后患者的病历资料。该患者于支架置入术后出现脑栓塞、严重脑水肿、急性肾功能不全、代谢性酸中毒、重症肺炎、心功能不全、横纹肌溶解综合征等一系列危重情况,并于早期应用连续性肾脏替代治疗(CRRT)及抗感染、抗血小板聚集等综合治疗,患者病情趋于平稳。对于个别行颈动脉支架置入术后可能出现脑栓塞、多脏器功能衰竭等危及生命的严重并发症者,可尽早应用CRRT,从而改善患者预后。A case of carotid artery stenting for severe stenosis of left subclavian artery and left internal carotid artery was reported in this paper.A series of critical conditions,involving cerebral embolism,severe brain edema,acute renal insufficiency,metabolic acidosis,severe pneumonia,cardiac insufficiency,and rhabdomyolysis syndrome occurred after stenting.Continuous renal replacement therapy(CRRT),anti-infection,anti-platelet aggregation and other comprehensive treatment were applied in the early stage,and the patient′s condition was stabilized.CRRT can be applied as early as possible to improve the prognosis of patients with life-threatening complications such as cerebral embolism and multi-organ failure after carotid artery stenting.

关 键 词：颈动脉支架置入术 并发症 脑栓塞 脑高灌注综合征 连续性肾替代治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]