颈动脉支架成形术后颅内出血临床分析

发布时间：2018-03-21 15:58

本文选题：颈动脉狭窄　切入点：颅内出血　出处：《介入放射学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨颈动脉支架成形术(CAS)后颅内出血的临床特点、发生机制及治疗。方法回顾性分析2008年1月至2017年1月收治的颈动脉狭窄行CAS术患者,记录并分析术后出血患者临床及影像学资料。结果 513例患者中5例(0.97%)发生颅内出血,均经术后头颅CT/DSA证实。其中男3例,女2例,平均年龄(71.4±5.0)岁;颈动脉狭窄率为90%~99%,出血时间为术中即刻至术后10 d;1例DSA显示同侧基底节区烟雾血管,1例DSA发现穿支动脉出血。3例接受药物保守治疗,其中1例恢复良好,2例死亡;2例接受血肿穿刺引流,遗留偏瘫。结论 CAS术后颅内出血发生率较低,但致死、致残率较高。发病原因较多,术前充分评估、危险因素筛选可降低发生率。出血后积极控制血压,予以镇静、停用抗凝药、减少/停用抗血小板药以及手术干预,可提高患者生存率。
[Abstract]:Objective to investigate the clinical features, mechanism and treatment of intracranial hemorrhage after carotid stenting. Methods from January 2008 to January 2017, patients with carotid artery stenosis treated with CAS were retrospectively analyzed. Results Intracranial hemorrhage (ICH) occurred in 5 of 513 patients (3 males and 2 females, with an average age of 71.4 卤5.0). The stenosis rate of carotid artery was 90 / 99. The bleeding time was from immediately to 10 days after operation in 1 case of DSA showing the ipsilateral basal ganglia smog vessel. 3 cases of perforating artery hemorrhage were found in DSA. 3 cases received conservative drug treatment. One case recovered well and 2 cases died of hematoma puncture drainage and hemiplegia. Conclusion the incidence of intracranial hemorrhage after CAS is lower, but the rate of death and disability is higher. Risk factors screening can reduce the incidence of blood pressure, sedation, stop anticoagulants, reduce / stop antiplatelet drugs and surgical intervention after bleeding, which can improve the survival rate of patients.
【作者单位】：郑州大学人民医院脑血管介入治疗中心、河南省介入治疗中心、河南省脑血管病防治中心;
【基金】：国家临床重点专科建设项目(2013~245)
【分类号】：R743

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