药物涂层球囊预扩联合支架置入治疗椎动脉起始部狭窄的临床疗效分析  

Clinical efficacy analysis of drug-coated balloon pre-amplification combined with stent placement in the treatment of stenosis at the beginning of the vertebral artery

作　　者：黄捷 王宁宁 于文武 刘林林 孙喜凤 高青青 HUANG Jie;WANG Ning-ning;YU Wen-wu;LIU Lin-lin;SUN Xi-feng;GAO Qing-qing(Cangzhou People′s Hospital,Cangzhou061000,China)

机构地区：[1]河北省沧州市人民医院,河北沧州061000

出　　处：《实用医院临床杂志》2022年第5期78-81,共4页Practical Journal of Clinical Medicine

基　　金：河北省医学科学研究课题计划(编号:20211631)。

摘　　要：目的 分析药物涂层球囊(DCB)预扩联合支架置入治疗椎动脉起始部狭窄的临床疗效。方法 2018年8月至2021年11月我院收治的椎动脉起始部狭窄患者126例,其中普通球囊+支架置入治疗74例(对照组),DCB+支架置入治疗52例(DCB组)。对比两组手术成功率、狭窄率、狭窄血管长度;血流动力学情况;神经功能及日常生活能力;术后1个月后循环缺血及再狭窄情况。结果 两组手术成功率均为100%。术后两组狭窄率、狭窄血管长度、血流动力学指标、美国国立卫生院神经功能缺损评分(NIHSS)评分较术前均降低,日常生活活动能力评分(ADL)及肢体运动功能Fugel-Meyer(FMA)较术前升高(P<0.05);术后DCB组收缩期峰值血流速度(PSV)和舒张末期峰值血流速度(EDV)值、NIHSS评分、再狭窄率均低于对照组,ADL及FMA评分高于对照组(P<0.05)。两组术后后循环缺血症状发生情况比较,差异无统计学意义(P>0.05)。结论 DCB预扩联合支架置入治疗椎动脉起始部狭窄,手术成功率高,血流动力学改善显著,降低了再狭窄发生率,可作为治疗椎动脉起始部狭窄的选择方案。Objective To analyze the clinical efficacy of drug-coated balloon(DCB) pre-expansion combined with stent placement in the treatment of stenosis at the beginning of vertebral artery.Methods From August 2018 to November 2021, 126 patients with vertebral artery stenosis were treated in our hospital. The patients were divided into a control group(n=74) and a DCB group(n=52). The control group was treated with ordinary balloon + stent implantation and the DCB group was treated with DCB + stent implantation. The operation success rate, stenosis rate, length of stenotic vessel, hemodynamics, neurological function and daily living ability as well as circulation ischemia and restenosis at 1 month after operation were compared between the two groups.Results The surgical success rate in the two groups was 100%. After operation, the stenosis rate, length of stenotic vessels, hemodynamic indexes, and National Institutes of Health Neurological Stroke Scale(NIHSS) score in the two groups were all decreased while activity of daily living(ADL) score and Fugel-Meyer Assessment(FMA) score were increased when compared with those before operation(P<0.05). After operation, peak systolic blood flow velocity(PSV) and end-diastolic blood flow velocity(EDV), NIHSS score and restenosis rate in the DCB group were lower while ADL and FMA scores were higher than those in the control group(P<0.05). There was no significant difference in the incidence of postoperative posterior circulation ischemia symptoms between the two groups(P>0.05).Conclusion DCB pre-expansion combined with stent placement in the treatment of stenosis at the beginning of the vertebral artery has a high success rate. It significantly improves the hemodynamics, and reduces restenosis rate. It can be used as a choice for the treatment of stenosis at the beginning of vertebral artery.

关 键 词：药物涂层球囊预扩 支架置入 椎动脉起始部狭窄 临床疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]