颅内动脉支架成形术中应用导引导管开窗导流技术的临床研究  

Clinical study on the application of guide catheter window guidance technology in intracranial artery stent angioplasty

作　　者：李志永 张梦彩 李春霖 刘佩佩 赵雪萌 唐灵涛 李英毅 胡鹏飞 王云 Li Zhiyong;Zhang Mengcai;Li Chunlin;Liu Peipei;Zhao Xuemeng;Tang Lingtao;Li Yingyi;Hu Pengfei;Wang Yun(Department of Neurology,Xingtai Third Hospital,Xingtai 054099,China;Department of Internal Medicine,Xindu District People′s Hospital,Xingtai 054001,China)

机构地区：[1]邢台市第三医院神经内科,邢台054099 [2]邢台市信都区人民医院内科,邢台054001

出　　处：《中国医师杂志》2023年第12期1849-1853,共5页Journal of Chinese Physician

基　　金：邢台市重点研发计划自筹项目(2022ZC091)。

摘　　要：目的探讨导引导管开窗导流技术在颅内动脉支架成形术中的应用价值。方法选取2021年1月至2022年12月邢台市第三医院收治的120例症状性颅内动脉粥样硬化性狭窄患者,采用随机数字表法将患者分为观察组(n=60)和对照组(n=60)。两组均给予颅内动脉支架成形术,其中观察组术中应用导引导管开窗导流技术。观察对比两组手术情况,手术前后血管狭窄程度,手术前、手术后1个月的蒙特利尔认知评估量表(MoCA)评分,术中并发症情况及预后情况。结果观察组手术时间、导管到位时间分别为(110.20±23.32)min、(11.32±2.01)min,明显少于对照组(均P<0.05)。观察组支架到位率、操作成功率分别为95.00%和96.67%,明显高于对照组(均P<0.05)。观察组术后责任血管狭窄程度为(32.29±7.11)%,明显轻于对照组[(44.43±8.15)%,P<0.05]。术后1个月两组MoCA评分较术前均明显改善(均P<0.05),且组间差异无统计学意义(P>0.05)。两组侧支循环闭塞、血管破裂发生率差异无统计学意义(P>0.05)。随访期间,观察组和对照组支架处再狭窄、颅内出血、再发缺血性脑卒中发生率比较差异无统计学意义(均P>0.05);观察组预后良好率为73.33%,明显高于对照组(53.33%,P<0.05)。结论颅内动脉支架成形术中应用导引导管开窗导流技术有较好的价值,有利于提高支架到位率和操作成功率,改善血管狭窄程度。Objective To explore the application value of guide tube fenestration and drainage technology in intracranial artery stenting surgery.Methods A total of 120 patients with symptomatic intracranial atherosclerotic stenosis admitted to the Xingtai Third Hospital from January 2021 to December 2022 were selected and randomly divided into an observation group(n=60)and a control group(n=60).Both groups were treated with intracranial artery stenting,with the observation group receiving guidance catheterization and window opening technique during the surgery.Two groups of surgeries were observed and compared:the degree of vascular stenosis before and after surgery,the Montreal Cognitive Assessment Scale(MoCA)scores before and one month after surgery,intraoperative complications,and prognosis.Results The surgical time and catheter placement time in the observation group were(110.20±23.32)minutes and(11.32±2.01)minutes,respectively,which were significantly shorter than those in the control group(all P<0.05).The stent placement rate and operation success rate in the observation group were 95.00%and 96.67%,respectively,significantly higher than those in the control group(all P<0.05).The degree of postoperative vascular stenosis in the observation group was(32.29±7.11)%,significantly milder than that in the control group[(44.43±8.15)%,P<0.05].One month after surgery,the MoCA scores of both groups improved significantly compared to before surgery(all P<0.05),and there was no statistically significant difference between the groups(P>0.05).There was no statistically significant difference in the incidence of collateral circulation occlusion and vascular rupture between the two groups(all P>0.05).During the follow-up period,there was no statistically significant difference in the incidence of restenosis,intracranial hemorrhage,and recurrent ischemic stroke between the observation group and the control group(all P>0.05);The good prognosis rate of the observation group was 73.33%,significantly higher than that of the control gro

关 键 词：颅内动脉硬化 血管成形术 支架 导引导管开窗导流 

分 类 号：R651.1[医药卫生—外科学]