支架成形术治疗老年颈动脉狭窄效果及危险因素分析

发布时间：2018-12-31 20:32

【摘要】：目的分析评价颈动脉支架成形术(CAS)治疗老年颈动脉狭窄的围手术期并发症、近中期疗效及危险因素。方法回顾性分析2011年6月至2014年6月收治的255例老年颈动脉狭窄患者临床资料,研究CAS术前危险因素(既往脑缺血史、高血压病史、吸烟史等)与围手术期并发症及近中期疗效的联系。结果术前所有患者改良Rankin量表(m RS)评分为平均(2.58±0.68)分,术后出院时66.7%患者(170/255)为平均(1.98±0.30)分(P0.001),术后3个月78.8%患者(201/255)为平均(1.67±0.53)分(P0.001),术后12个月98.8%患者(252/255)为平均(1.84±0.38)分(P0.001)。术后出现脑梗死7例,短暂性脑缺血发作(TIA)8例,脑过度灌注综合征8例,既往脑梗死史、糖尿病且控制不佳、冠心病、未戒烟、高血压且控制不佳是危险因素;术后3个月发生TIA 13例,支架内再狭窄3例,既往脑梗死史及高脂血症是危险因素;术后12个月发生脑梗死10例,TIA 10例,支架内再狭窄5例,既往脑梗死史、吸烟史、高脂血症且控制不佳是危险因素。结论 CAS治疗老年颈动脉狭窄的有效性及安全性高,既往脑缺血史、高血压史及高脂血症是危险因素,术前需得到有效控制。
[Abstract]:Objective to evaluate the perioperative complications, efficacy and risk factors of carotid stenting with (CAS) in elderly patients with carotid artery stenosis. Methods the clinical data of 255 elderly patients with carotid artery stenosis from June 2011 to June 2014 were retrospectively analyzed and the risk factors (previous cerebral ischemia history, hypertension history) before CAS were studied. History of smoking, etc.) is associated with perioperative complications and near-and mid-term outcomes. Results the mean (m RS) score of modified Rankin scale was (2.58 卤0.68) in all patients before operation, and the average score was (1.98 卤0.30) in 66.7% patients (170 / 255) at postoperative discharge (P0.001). Three months after operation, 78.8% of the patients (201 / 255) had an average score of (1.67 卤0.53) (P 0.001), and 12 months of operation (98.8%) (252 / 255) had an average score of (1.84 卤0.38) (P 0.001). The risk factors were cerebral infarction in 7 cases, transient ischemic attack in 8 cases, cerebral hyperperfusion syndrome in 8 cases, previous cerebral infarction history, diabetes mellitus and poor control, coronary heart disease, non-smoking cessation, hypertension and poor control. There were 13 cases of TIA and 3 cases of restenosis in stent 3 months after operation. The history of cerebral infarction and hyperlipidemia were the risk factors. Cerebral infarction occurred in 10 cases, TIA in 10 cases, restenosis in stent in 5 cases at 12 months after operation. The risk factors were previous cerebral infarction history, smoking history, hyperlipidemia and poor control. Conclusion CAS is effective and safe in the treatment of carotid artery stenosis in the elderly. The history of cerebral ischemia, hypertension and hyperlipidemia are the risk factors, which should be effectively controlled before operation.
【作者单位】：上海中医药大学附属龙华医院放射科;复旦大学附属华山医院放射科;
【分类号】：R743

【相似文献】