支架置入治疗椎动脉起始部狭窄的应用效果
|
摘要
目的探讨分析应用支架置入治疗椎动脉起始部狭窄患者的临床效果及安全性。方法系统性回顾2015年4月～2016年2月于我院神经内科就诊的58例椎动脉起始部狭窄患者,按照治疗方法的不同分为实验组和对照组,每组各29例。对照组给予口服药物治疗,实验组在对照组基础上给予支架置入治疗,全部患者随访1年,对比两组治疗前及随访1年后的椎动脉狭窄率、美国国立卫生研究院卒中量表(NIHSS)评分及脑血管事件发生情况。结果实验组的治疗总有效率显著高于对照组(P<0.05);随访1年后,实验组的椎动脉狭窄率及NIHSS评分显著低于对照组(P<0.05);随访期间,实验组患者的脑血管事件总发生率显著低于对照组(P<0.05);两组患者的死亡率比较,差异无统计学意义(P>0.05)。结论相比于口服药物治疗,采用支架置入治疗椎动脉起始部狭窄对提高患者预后效果、改善血管狭窄程度、降低脑血管事件的发生及死亡率有显著意义,临床效果显著,值得推广应用。
Objective To explore and analyze the clinical effect and safety of stent placement in the treatment of vertebral artery stenosis. Methods A systematic review of 58 patients with vertebral artery stenosis in Department of Neurology of our hospital from April 2015 to February 2016 was carried out. The patients were divided into the experimental group and the control group according to different treatment methods, 29 patients in each group. The control group was given oral medication, and the experimental group was treated with stent placement on tha basis of the control group. All patients were followed up for 1 year. The rate of vertebral artery stenosis, the national institutes of health stroke scale(NIHSS) score and cerebrovascular events were compared before treatment and after treatment 1 year followup visit between the two groups. Results The total treatment efficiency of the experimental group was significantly higher than that of the control group(P<0.05). After 1 year of follow-up, the rate of vertebral artery stenosis and NIHSS score in the experimental group were significantly lower than those in the control group(P<0.05). During the follow-up,the total incidence of cerebrovascular events in the experimental group was significantly lower than that of the control group(P<0.05). There was no significant difference in mortality between the two groups(P>0.05). Conclusion Compared with oral medication, stent placement in the treatment of vertebral artery stenosis has a significant effect on improving the prognosis of patients, improving the degree of vascular stenosis, reducing the occurrence and mortality of cerebrovascular events, and has a significant clinical effect, which is worthy of popularization and application.
Objective To explore and analyze the clinical effect and safety of stent placement in the treatment of vertebral artery stenosis. Methods A systematic review of 58 patients with vertebral artery stenosis in Department of Neurology of our hospital from April 2015 to February 2016 was carried out. The patients were divided into the experimental group and the control group according to different treatment methods, 29 patients in each group. The control group was given oral medication, and the experimental group was treated with stent placement on tha basis of the control group. All patients were followed up for 1 year. The rate of vertebral artery stenosis, the national institutes of health stroke scale(NIHSS) score and cerebrovascular events were compared before treatment and after treatment 1 year followup visit between the two groups. Results The total treatment efficiency of the experimental group was significantly higher than that of the control group(P<0.05). After 1 year of follow-up, the rate of vertebral artery stenosis and NIHSS score in the experimental group were significantly lower than those in the control group(P<0.05). During the follow-up,the total incidence of cerebrovascular events in the experimental group was significantly lower than that of the control group(P<0.05). There was no significant difference in mortality between the two groups(P>0.05). Conclusion Compared with oral medication, stent placement in the treatment of vertebral artery stenosis has a significant effect on improving the prognosis of patients, improving the degree of vascular stenosis, reducing the occurrence and mortality of cerebrovascular events, and has a significant clinical effect, which is worthy of popularization and application.
引文
[1]王俊,严永兴,钟长扬,等.支架成形术与单纯药物治疗老年症状性椎动脉狭窄患者的疗效比较[J].心脑血管病防治,2018,18(2):114-117.
[2]孙玉杰,丁健,张贤军,等.颅内动脉狭窄部位对支架成形术安全性影响研究[J].中国现代神经疾病杂志,2017,17(11):806-811.
[3]王健,陈德文,姚敏.血管支架成形术治疗缺血性脑血管病的临床疗效观察[J].当代医学,2018,24(27):28-30.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组,中华医学会神经病学分会神经血管介入协作组.中国缺血性脑血管病血管内介入诊疗指南2015[J].中华神经科杂志,2015,48(10):830-837.
[5]李朱勤,刘武,邓宇平,等.自膨式与球囊扩张支架治疗椎动脉颅内段狭窄患者的临床疗效对比分析[J].现代诊断与治疗,2016,27(2):200-202.
[6]周传国,魏宝杰,王剑锋,等.双支架联合植入治疗恶性胆管梗阻合并胃流出道梗阻[J].介入放射学杂志,2018,27(9):847-852.
[7]钟涛,刘东涛,马向科,等.无症状性颈动脉狭窄患者不同治疗方式后的临床结局[J].中国卒中杂志,2018,13(8):790-794.
[8]李敏,朱继存.椎动脉V4段狭窄的介入治疗疗效观察[J].中国实用神经疾病杂志,2018,3(17):1-9.
[9]王贤灿,尚玉强,李炳,等.Hybrid手术在复杂Stanford B型夹层中的临床应用[J].转化医学杂志,2018,7(5):294-297.
[10]祝雪芳,魏晓智.颈动脉狭窄患者支架置入手术后的血管超声影像研究[J].现代实用医学,2018,30(9):1240-1242,1262.
[11]徐林,潘晓东,李隽,等.MSCT血管成像技术对椎动脉狭窄程度评估的比较研究[J].颈腰痛杂志,2015,36(5):363-366.
[12]代鸣明,苏庆杰,于航,等.颈动脉支架置入术对不同年龄段的颈动脉狭窄患者血流动力学的影响[J].中国医药导报,2018,15(26):58-61.
[14]奚宁宁.老年缺血性脑血管疾病介入血管支架成型术与药物保守治疗短长期疗效及可能产生并发症对比[J].当代医学,2018,24(26):111-115.
[15]孙玉杰,丁健,张贤军,等.颅内动脉狭窄部位对支架成形术安全性影响研究[J].中国现代神经疾病杂志,2017,17(11):806-811.
[16]何旭英,段传志,张剑波,等.支架置入治疗椎-基底动脉延长扩张症安全性和有效性的初步观察[J].中国脑血管病杂志,2018,15(9):483-488.
[17]李建标,何锦照,钟小劲,等.锁骨下动脉支架置入术治疗锁骨下动脉狭窄的临床研究[J].临床医学工程,2018,25(6):699-700.
[18]闫宏伟,徐善才,张广,等.椎动脉起始部支架置入后再狭窄因素的研究进展[J].中国脑血管病杂志,2018,15(7):378-381.
[2]孙玉杰,丁健,张贤军,等.颅内动脉狭窄部位对支架成形术安全性影响研究[J].中国现代神经疾病杂志,2017,17(11):806-811.
[3]王健,陈德文,姚敏.血管支架成形术治疗缺血性脑血管病的临床疗效观察[J].当代医学,2018,24(27):28-30.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组,中华医学会神经病学分会神经血管介入协作组.中国缺血性脑血管病血管内介入诊疗指南2015[J].中华神经科杂志,2015,48(10):830-837.
[5]李朱勤,刘武,邓宇平,等.自膨式与球囊扩张支架治疗椎动脉颅内段狭窄患者的临床疗效对比分析[J].现代诊断与治疗,2016,27(2):200-202.
[6]周传国,魏宝杰,王剑锋,等.双支架联合植入治疗恶性胆管梗阻合并胃流出道梗阻[J].介入放射学杂志,2018,27(9):847-852.
[7]钟涛,刘东涛,马向科,等.无症状性颈动脉狭窄患者不同治疗方式后的临床结局[J].中国卒中杂志,2018,13(8):790-794.
[8]李敏,朱继存.椎动脉V4段狭窄的介入治疗疗效观察[J].中国实用神经疾病杂志,2018,3(17):1-9.
[9]王贤灿,尚玉强,李炳,等.Hybrid手术在复杂Stanford B型夹层中的临床应用[J].转化医学杂志,2018,7(5):294-297.
[10]祝雪芳,魏晓智.颈动脉狭窄患者支架置入手术后的血管超声影像研究[J].现代实用医学,2018,30(9):1240-1242,1262.
[11]徐林,潘晓东,李隽,等.MSCT血管成像技术对椎动脉狭窄程度评估的比较研究[J].颈腰痛杂志,2015,36(5):363-366.
[12]代鸣明,苏庆杰,于航,等.颈动脉支架置入术对不同年龄段的颈动脉狭窄患者血流动力学的影响[J].中国医药导报,2018,15(26):58-61.
[14]奚宁宁.老年缺血性脑血管疾病介入血管支架成型术与药物保守治疗短长期疗效及可能产生并发症对比[J].当代医学,2018,24(26):111-115.
[15]孙玉杰,丁健,张贤军,等.颅内动脉狭窄部位对支架成形术安全性影响研究[J].中国现代神经疾病杂志,2017,17(11):806-811.
[16]何旭英,段传志,张剑波,等.支架置入治疗椎-基底动脉延长扩张症安全性和有效性的初步观察[J].中国脑血管病杂志,2018,15(9):483-488.
[17]李建标,何锦照,钟小劲,等.锁骨下动脉支架置入术治疗锁骨下动脉狭窄的临床研究[J].临床医学工程,2018,25(6):699-700.
[18]闫宏伟,徐善才,张广,等.椎动脉起始部支架置入后再狭窄因素的研究进展[J].中国脑血管病杂志,2018,15(7):378-381.