药物球囊预扩张联合裸金属支架治疗椎动脉起始部狭窄的效果  

Effect of drug balloon pre-dilation combined with bare metal stent in the treatment of vertebral artery stenosis at the beginning

作　　者：黄捷 王宁宁 于文武 刘林林 孙喜凤 高青青 王海霞 时婧 侯华玲 张海燕 孙维明 HUANG Jie;WANG Ningning;YU Wenwu;LIU Linlin;SUN Xifeng;GAO Qingqing;WANG Haixia;SHI Jing;HOU Hualing;ZHANG Haiyan;SUN Weiming(Cangzhou People’s Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院,河北沧州061000

出　　处：《中国实用神经疾病杂志》2023年第11期1390-1394,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河北省2021年度医学科学研究课题(编号:20211631)。

摘　　要：目的观察药物球囊预扩张联合裸金属支架治疗椎动脉起始部狭窄的效果。方法选取2018-08—2021-07沧州市人民医院收治的104例椎动脉起始部狭窄患者为研究对象,采用随机数字表法分为研究组(给予药物球囊预扩张联合裸金属支架置入,52例)和对照组(给予普通球囊扩张支架置入,52例)。对比2组患者手术成功率及手术前后血管狭窄率,以及手术前后神经功能改善情况。随访1 a,对比2组患者血管内再狭窄发生情况及围手术期并发症发生率。结果研究组手术成功率(98.08%)与对照组(96.15%)比较差异无统计学意义(χ^(2)=0.343,P=0.558);研究组术后6、12个月血管狭窄率分别为(12.43±3.18)%、(13.61±3.25)%,显著低于对照组的(13.78±3.62)%、(15.26±4.78)%(t=2.020、2.058,P=0.046、0.042)。研究组术后1、3、6、12个月美国国立卫生研究院卒中量表(NIHSS)评分分别为(2.14±0.59)分、(1.93±0.47)分、(1.75±0.43)分、(1.48±0.32)分,显著低于对照组的(2.51±0.73)分、(2.23±0.68)分、(2.01±0.40)分、(1.84±0.46)分(t=2.843、2.617、3.192、4.633,P=0.005、0.010、0.002、<0.001)。术后6、12个月研究组血管内再狭窄发生率(5.77%、9.62%)均显著低于对照组(19.23%、26.92%,χ^(2)=4.308、5.216,P=0.038、0.022)。研究组并发症发生率(5.77%)与对照组(13.46%)比较差异无统计学意义(χ^(2)=1.770,P=0.183)。结论采用药物涂层球囊预扩张联合裸金属支架置入的方法治疗椎动脉起始部狭窄,在保证手术成功率、安全性、有效性的前提下,可有效减小血管狭窄率、改善神经功能、降低再狭窄发生率。Objective To observe the effect of drug balloon pre-dilation combined with bare metal stent in the treatment of vertebral artery stenosis at the origin.Methods A total of 104 patients with vertebral artery stenosis at the beginning of the vertebral artery who were treated in Cangzhou Peoples Hospital from August 2018 to July 2021 were selected and divided into study group(with drug balloon pre-dilation combined with bare metal stent placement,52 cases)and control group(with the placement of ordinary balloon-expandable stents,52 cases by random number table method).The surgical success rate and vascular stenosis rate before and after surgery were compared between the two groups.The improvement of neurological function in the two groups before and after surgery was compared.The patients were followed up for 1 year,and the incidence of intravascular restenosis was compared between the two groups.The incidence of perioperative complications in the two groups were compared.Results The success rate of operation in the study group was 98.08%,and there was no significant difference between the study group and the control group(96.15%)(χ^(2)=0.343,P=0.558).The rate of vascular stenosis in the study group((12.43±3.18)%and(13.61±3.25)%)at 6 and 12 months after surgery was lower than that in the control group((13.78±3.62)%and(15.26±4.78)%)(t=2.020,2.058,P=0.046,0.042).The NIHSS scores of the study group at 1,3,6 and 12 months after operation(2.14±0.59,1.93±0.47,1.75±0.43 and 1.48±0.32)were lower than those of the control group(2.51±0.73,2.23±0.68,2.01±0.40 and 1.84±0.46)(t=2.843,2.617,3.192,4.633,P=0.005,0.010,0.002,<0.001).The incidence of intravascular restenosis in the study group(5.77%,9.62%)was lower than that in the control group(19.23%,26.92%)at 6 and 12 months after surgery(χ^(2)=4.308,5.216,P=0.038,0.022).The complication rate of the study group was 5.77%,and there was no significant difference between the study group and the control group(13.46%)(χ^(2)=1.770,P=0.183).Conclusion Drug-coated balloon pr

关 键 词：椎动脉起始部狭窄 药物球囊预扩张 裸金属支架 再狭窄 

分 类 号：R743.9[医药卫生—神经病学与精神病学]