颅外颈动脉和椎动脉狭窄支架置入术围术期并发症及危险因素分析

发布时间：2018-01-25 06:39

  本文关键词： 颈动脉狭窄 椎底动脉供血不足 支架 手术中并发症 危险因素　出处：《中华老年心脑血管病杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨血管内支架置入术治疗颅外颈动脉和椎动脉狭窄患者围术期并发症特点及危险因素,制订术前评估策略。方法连续选择我院行血管内支架置入术的患者279例,根据手术方式分为:颈动脉支架组207例及椎动脉支架组72例,术后随访30d,根据围术期内是否存在并发症分为并发症组144例和无并发症组135例。结果颈动脉支架组心动过缓(10.6%vs 1.4%,P=0.027)及血压降低(22.7%vs 5.6%,P=0.001)的比例明显高于椎动脉支架组。并发症组患者随着年龄、狭窄程度的增加,并发症比例明显升高,而无并发症组明显降低(P0.05)。logistic回归分析显示,年龄、高血压、动脉狭窄程度、狭窄长病变、Ⅲ型主动脉弓、术者操作经验及操作时间为围术期并发症的独立危险因素,球囊预扩为围术期并发症的保护因素。结论患者相关因素及术中因素均可显著影响围术期并发症的发生,术前充分准备、术中规范操作及术后严密监测对防治围术期并发症尤为重要。
[Abstract]:Objective to investigate the characteristics and risk factors of perioperative complications in patients with extracranial carotid artery and vertebral artery stenosis treated by endovascular stenting. Methods 279 consecutive patients underwent endovascular stenting in our hospital were divided into carotid stenting group (207 cases) and vertebral artery stenting group (72 cases). The patients were followed up for 30 days. According to whether there were complications during the perioperative period, there were 144 cases in the complication group and 135 cases in the non-complication group. Results the carotid artery stent group had a bradycardia 10.6 vs 1.4%. The proportion of P0. 027) and lower blood pressure (22. 7 vs 5. 6 P0. 001) was significantly higher than that in the vertebral artery stenting group. The degree of stenosis increased with age in the complication group. The proportion of complications was significantly increased, while in the non-complication group, P 0.05U. Logistic regression analysis showed that age, hypertension, degree of arterial stenosis, long lesion of stenosis, type 鈪，

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