颈动脉分叉处支架置入术后严重持续性低血压的危险因素  

Risk factors of severe persistent hypotension after carotid artery bifurcation stenting

作　　者：曲永强 赵泽宇[1] 吴兴原 韩玮 段瑞生[1] 李衍滨[1] 李亨[1] QU Yongqiang;ZHAO Zeyu;WU Xingyuan;HAN Wei;DUAN Ruisheng;LI Yanbin;LI Heng(Department of Neurology,The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Institute of Neuroimmunology,Shandong Key Laboratory of Rheumatic Disease and Translational Medicine,Jinan 250014,Shandong,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)神经病学,山东省神经免疫研究所,山东省风湿免疫病转化医学重点实验室,山东济南250014

出　　处：《山东大学学报（医学版）》2023年第7期78-82,89,共6页Journal of Shandong University:Health Sciences

基　　金：山东第一医科大学学术提升计划(2019QL013)。

摘　　要：目的 分析颈动脉分叉处支架置入术后严重持续性低血压的危险因素。方法 回顾性分析2014年10月至2022年4月山东第一医科大学第一附属医院神经内科177例(181处病变)颈动脉分叉处狭窄并接受支架置入术患者术后严重持续性低血压的危险因素。采用单因素和多因素Logistic回归法分析术后严重持续性低血压的危险因素。结果 177例患者术后严重持续性低血压的发生率为53.1%。单因素分析显示,支架直径较大、术中应用阿托品、球囊扩张直径>5 mm、偏心狭窄和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的危险因素。多因素分析显示,术中应用阿托品、球囊扩张直径>5 mm和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的独立危险因素。结论 颈动脉分叉处支架置入术后发生血流动力学损害是常见的并发症,术中应用阿托品、球囊扩张直径>5 mm和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的独立危险因素。Objective To analyze the risk factors of severe persistent hypotension after carotid artery bifurcation stenting.Methods Clinical data of 177 patients(181 lesions) with carotid artery bifurcation stenosis who underwent stenting during Oct.2014 and Apr.2022 were retrospectively analyzed.The risk factors for postoperative severe persistent hypotension were analyzed with univariate and multivariate Logistic regression models.Results The incidence of severe persistent hypotension was 53.1%.Univariate analysis showed that large stent diameter,intraoperative use of atropine,balloon dilation diameter >5 mm,eccentric stenosis and severe stenosis were risk factors of severe persistent hypotension.Multivariate analysis indicated that intraoperative use of atropine,balloon dilation diameter >5 mm and severe stenosis were independent risk factors.Conclusions Hemodynamic impairment is a common complication after carotid artery bifurcation stenting.Intraoperative use of atropine,balloon dilation diameter 5mm and severe stenosis are independent risk factors of severe persistent hypotension.

关 键 词：颈动脉分叉处狭窄 支架 低血压 危险因素 

分 类 号：R574[医药卫生—消化系统]