摘要
目的探讨Wingspan支架置入治疗重度大脑中动脉狭窄的疗效性和安全性。方法回顾性分析86例重度大脑中动脉狭窄患者行Wingspan支架置入前后的临床资料。所有患者经经颅多普勒(TCD)、CT血管造影(CTA)及全脑数字减影血管造影(DSA)后证实为重度大脑中动脉狭窄(狭窄率≥70%),行择期大脑中动脉血管内Wingspan支架置入术。分析患者术前与术后的CT灌注最大峰值时间(TTP)、狭窄程度及术前与术后1周的NIHSS评分的变化情况,同时分析患者术中和术后的并发症。结果 86例患者支架置入成功,成功率为100%。术中出现3例轻度脑血管痉挛,术后出现5例高灌注综合征,1例于术后3d出血性死亡。86例患者术前患侧TTP为(14.69±3.25)s,术后1d的TTP为(9.32±3.76)s,差异有统计学差异(P<0.01)。术前大脑中动脉平均狭窄程度为(81.27±10.43)%,术后即刻平均狭窄程度为(4.53±1.31)%,差异有统计学差异(P<0.01)。85例患者美国国立卫生院神经功能缺损(NIHSS)评分为术前(11.71±4.53)分,术后为(8.39±3.82)分,差异有统计学意义(P<0.01),神经功能改善率平均为29.45%。结论支架置入治疗重度大脑中动脉狭窄具有较好的疗效和较高的安全性,是治疗和预防缺血性脑卒中的重要治疗手段之一。
Objective To investigate the curative effects and security of Wingspan stent implantation in the treatment of severe middle cerebral artery（MCA） stenosis .Methods The clinical data in 86 cases with severe MCA stenosis before and after Wingspan stent implantation were collected and performed the retrospective analysis .After the severe stenosis of MCA （stenosis rate ≥ 70% ） in all the patients was confirmed by the transcranial doppler （TCD） ,CT angiography（CTA） and digital subtraction angiography（DSA） ,the elective Wingspan stent implantation of MCA was performed .The time‐to‐peak of the CT perfusion（CTP） ,stenosis degree of MCA before and after the stent implantation and the National Institutes of Health Stroke Scale（NIHSS） score were measured before operation and at 1 week after operation ,and also the intraoperative and postoperative complications were analyzed .Results The MCA stent implantation was successfully performed in 86 cases with the success rate of 100% .3 cases occured minor cerebral angiospasm during operation ,5 cases occured hypertransfusion syndrome after stent implantation ,and 1 case was dead on 3 postoperative 3 d because of intracerebral hemorrhage .The affected side TTP in 86 cases before operation was（14 .69 ± 3 .25）s ,while which on postoperative 1 d was（9 .32 ± 3 .76）s ,the difference was statistically significant（P 〈 0 .01） .The mean stenosis degrees of MCA before and immediately after stent implantation were （81 .27 ± 10 .43）% and （4 .53 ± 1 .31）% respectively ,the difference was statistically significant（P〈 0 .01） .Addition‐ally ,the NIHSS score before and after operation in 85 cases were（11 .71 ± 4 .53）points and（8 .39 ± 3 .82） points ,and the difference was statistical significant（P〈 0 .01） ,and the improvement rate of the neurologic deficit scores（NDS） was 29 .45% .Conclusion Stent implantation for treating severe MCA stenosis has a better curative effect and higher security ,and is one of the most important curative methods for the treatment and prevention of ischemic cerebral stroke .
出处
《检验医学与临床》
CAS
2015年第19期2865-2867,共3页
Laboratory Medicine and Clinic
作者简介
王玥，女，硕士，主治医师，主要从神经病学临床工作。
通讯作者，E—mail：yangqwmlys@hotmail．com。
