颈动脉支架植入术后血流动力学紊乱的危险因素分析

发布时间：2018-02-09 21:15

本文关键词： 颈动脉支架血流动力学影响因素　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨颈内动脉支架植入术(CAS)患者血流动力学改变的影响因素。方法:采用回顾性分析的方法收集接受颈内动脉支架植入术(CAS)患者的临床资料,使用统计学方法分析影响血流动力学不稳定(HI)和持续性血流动力学不稳定(PHI)的相关因素,并随访发生PHI的患者,研究CAS对血压的远期影响。结果:根据入组标准,有60例患者接受CAS,共有33例发生了HI,有16例持续时间大于6小时。10例患者接受多巴胺等升压药物治疗。根据单因素分析,饮酒(p=0.047),偏心性狭窄(p=0.001),病变距离分叉长度(p=0.009)为HI发生的相关因素,根据多因素回顾分析,偏心性狭窄(p=0.006),病变距离分叉长度(p=0.026)为HI的独立因素。同时,偏心性狭窄(p=0.006)也为PHI的独立危险因素。随访了10例发生PHI的患者6个月后血压、心率的变化情况,与上述患者术后48小时的收缩压、心率进行对比后,发现其收缩压平均增长16.333mmHg,心率平均增长5.8次/分。所有患者在1年后血压达到正常范围。结论:CAS患者术后血液动力学改变与饮酒,偏心性狭窄,病变到分叉的距离诸因素相关。根据患者的临床基本情况与病情特点对患者术前进行积极干预可以有效的降低HI的发生,改善患者的预后。CAS对患者远期血流动力学的改变不明显。
[Abstract]:Objective: to investigate the influencing factors of hemodynamic changes in patients undergoing internal carotid artery stenting (CAS). Methods: the clinical data of patients undergoing internal carotid stenting (CAS) were collected by retrospective analysis. The factors related to hemodynamic instability (HI) and persistent hemodynamic instability (PHI) were analyzed by statistical method. Patients with PHI were followed up to study the long-term effects of CAS on blood pressure. There were 60 patients who received CAS, 33 patients who had HIS, 16 patients who had duration longer than 6 hours, 10 patients who were treated with dopamine and other blood pressure drugs, according to univariate analysis. Drinking p0. 047, eccentric stenosis, p0. 001, and distance of lesion distance) were the related factors of HI. According to the retrospective analysis of many factors, eccentricity stenosis (p0. 006) and distance of lesion (p0. 026) were independent factors of HI. 10 patients with PHI were followed up for 6 months. The changes of blood pressure and heart rate were compared with the systolic blood pressure and heart rate of 48 hours after operation. It was found that the systolic blood pressure increased 16.333mm Hgand the heart rate increased 5.8 times per minute. The blood pressure of all patients reached normal range after one year. The distance between lesion and bifurcation is related to many factors. According to the basic clinical situation and the characteristics of the patient's condition, the positive intervention before operation can effectively reduce the occurrence of HI. No significant changes in long-term hemodynamics were observed by improving prognosis. CAS.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.3

【相似文献】