分期颈动脉支架置入术与颈动脉内膜剥脱术治疗双侧颈动脉狭窄所致缺血性脑卒中的效果及对脑部血流情况的影响  

Effects of staging carotid artery stenting and carotid endarterectomy on ischemic stroke caused by bilateral carotid artery stenosis and its influence on cerebral blood flow

作　　者：华锋 王飒 刘佳豪 黄意 苗志刚 HUA Feng;WANG Sa;LIU Jiaohao;HUANG Yi;MIAO Zhigang(Xianyang Hospital of Yan'an University,Xianyang 712000,China)

机构地区：[1]延安大学咸阳医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2021年第18期64-66,共3页Clinical Research and Practice

摘　　要：目的探讨分期颈动脉支架置入术(CAS)与颈动脉内膜剥脱术(CEA)治疗双侧颈动脉狭窄所致缺血性脑卒中的效果及对脑部血流情况的影响。方法抽取2018年12月至2020年4月收治的150例双侧颈动脉狭窄所致缺血性脑卒中患者,以随机数字表法将其分为对照组及观察组,每组75例。对照组行分期CEA,观察组行分期CAS。比较两组的治疗效果。结果观察组的治疗总有效率为97.33%,略高于对照组的93.33%,但差异无统计学意义(P>0.05)。术后,观察组的ICA-PSV、ICA-RI、MCA-PSV、MCA-PI、CVR均优于对照组(P<0.05)。术后,观察组的NIHSS、MMSE评分均优于对照组(P<0.05)。观察组术后并发症总发生率为2.67%,低于对照组的12.00%(P<0.05)。结论分期CAS、CEA在双侧颈动脉狭窄所致缺血性脑卒中患者中均具有较高应用价值,但前者可显著改善患者脑部血流情况及神经功能缺损程度,还可促使患者认知功能恢复,减少术后并发症发生。Objective To explore the effect of staging carotid artery stent(CAS)and carotid endarterectomy(CEA)on ischemic stroke caused by bilateral carotid artery stenosis and its influence on cerebral blood flow.Methods A total of 150 patients with ischemic stroke caused by bilateral carotid artery stenosis admitted from December 2018 to April 2020 were extracted and divided into control group and observation group by random number table method,with 75 cases in each group.The control group was treated with staging CEA,and the observation group was treated with staging CAS.The treatment effects of the two groups were compared.Results The total effective rate of treatment of the observation group was 97.33%,which was slightly higher than 93.33%of the control group,but the difference was not statistically significant(P>0.05).After operation,the ICA-PSV,ICA-RI,MCA-PSV,MCA-PI and CVR of the observation group were better than those of the control group(P<0.05).After operation,NIHSS and MMSE scores of the observation group were better than those of the control group(P<0.05).The total incidence of postoperative complications in the observation group was 2.67%,which was lower than 12.00%in the control group(P<0.05).Conclusion Staging CAS and CEA have higher application value in patients with ischemic stroke caused by bilateral carotid artery stenosis,but the former can significantly improve the cerebral blood flow and the degree of neurological deficit,promote the recovery of cognitive function,and reduce the occurrence of postoperative complications.

关 键 词：颈动脉支架置入术 颈动脉内膜剥脱术 缺血性脑卒中 脑部血流 

分 类 号：R653[医药卫生—外科学]