5mm球囊预扩张治疗颈动脉重度狭窄的可行性分析  

Feasibility Analysis of 5mm Balloon Pre-dilation in the Treatment of Severe Carotid Stenosis

作　　者：凌端强 侯国欣 刘磊[1] Ling Duanqiang;Hou Guoxin;Liu Lei(Intervention Department,The Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450000,Henan)

机构地区：[1]河南中医药大学第五临床医学院<郑州人民医院>介入科,河南郑州450000

出　　处：《哈尔滨医药》2024年第3期11-13,共3页Harbin Medical Journal

摘　　要：目的分析5mm球囊预扩张治疗颈动脉重度狭窄的可行性。方法回顾83例颈动脉重度狭窄患者资料,所有患者均接受球囊扩张+颈动脉支架置入术治疗,根据预扩张球囊直径,将患者分为A、B两组,A组使用4mm球囊(43例),B组使用5mm球囊(40例)。观察两组患者手术情况、血流动力[狭窄处收缩期峰值流速(PSV)、舒张期最低血流速度(EDV)]、内皮功能[内皮素(ET-1)、血管性假性血友病因子(vWF)]、围手术期并发症、预后差异。结果两组手术成功率比较差异无统计学意义(P>0.05),B组残余狭窄率低于A组,差异有统计学意义(P<0.05);术后1d,两组PSV、EDV均较同组术前下降,且B组低于A组,差异有统计学意义(P<0.05);两组vWF、ET-1较同组术前上升,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);两组围手术期并发症及预后比较差异无统计学意义(P>0.05)。结论使用5mm球囊预扩张后行支架介入治疗可有效改善颈动脉重度狭窄患者的狭窄动脉,狭窄残余率较常规4mm更低,血流动力改善更佳,同时内皮功能及安全性表现无明显差异,有较高临床可行性。Objective To analyze the feasibility of 5mm balloon pre-dilation in the treatment of severe carotid stenosis.Methods The data of 83 patients with severe carotid stenosis were reviewed.All patients received balloon dilation+carotid artery stent implantation.Patients were divided into group A and group B according to the diameter of the pre-dilated balloon.Group A used 4mm balloon(43 cases)and Group B used 5mm balloon(40 cases).The differences of operation,hemodynamics(PSV,EDV),endothelial function(ET-1,vWF),perioperative complications and prognosis between the two groups were observed.Results There was no significant difference in the success rate of operation between the two groups(P>0.05),and the rate of residual stenosis in group B was lower than that in group A,the difference was statistically significant(P<0.05).One day after operation,PSV and EDV in both groups were lower than those in the same group before operation,and group B was lower than group A,the difference was statistically significant(P<0.05).vWF and ET-1 of the two groups were higher than those of the same group before surgery,with statistical significance(P<0.05),but there was no statistical significance between the two groups(P>0.05).There were no significant differences in perioperative complications and prognosis between the two groups(P>0.05).Conclusions Stent interventional therapy after 5mm balloon pre-dilation can effectively improve the stenosis in patients with severe carotid stenosis,the residual stenosis rate is lower than that of conventional 4mm,and the hemodynamic improvement is better.At the same time,there is no significant difference in endothelial function and safety performance,which has high clinical feasibility.

关 键 词：球囊预扩张治疗 颈动脉重度狭窄 狭窄残余率 血流动力 内皮功能 围手术期并发症 预后 

分 类 号：R543.5[医药卫生—心血管疾病]