本文選題：頸總動脈弓上狹窄 + 球囊擴(kuò)張式支架　； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：【目的】探討球囊擴(kuò)張式支架治療癥狀性頸總動脈弓上開口狹窄的有效性及安全性。【方法】對經(jīng)顱腦CT血管成像(CTA)或腦血管造影術(shù)(DSA)證實(shí)為椎動脈起始部重度狹窄(70%)的52例癥狀性頸總動脈弓上開口重度狹窄患者進(jìn)行血管內(nèi)支架治療,男34例,女18例,年齡52歲~79歲,平均(65.39±8.97)歲。術(shù)前完善一般常規(guī)生化、顱腦CT或MRI、CTA、DSA等檢查,并于入院和出院時(shí)進(jìn)行NIHSS評分,血管狹窄程度采用北美癥狀性頸動脈內(nèi)膜切除試驗(yàn)(NASCET)測量頸內(nèi)動脈狹窄的方法進(jìn)行評價(jià)。在局部麻醉下,以改良Seldinger技術(shù)穿刺股動脈,置入動脈鞘,沿0.035inch微導(dǎo)絲送入球囊擴(kuò)張式支架,并觀察圍手術(shù)期并發(fā)癥。【結(jié)果】52例頸總動脈弓上開口狹窄的患者進(jìn)行了血管內(nèi)支架置入術(shù),共置入支架51枚,手術(shù)成功率為98.08%。遠(yuǎn)端腦保護(hù)裝置均未在手術(shù)操作過程中使用。圍手術(shù)期的并發(fā)癥為5.77%,其中包括術(shù)中大腦中動脈水平段栓塞1例,引起大面積的腦梗死;術(shù)后高灌注綜合征2例;1例手術(shù)失敗。手術(shù)前后NIHSS評分(6.21±2.20,2.25±1.80,P0.05)、狹窄率(87.90%±7.60%,8.40%±2.30%,P0.05),差異有統(tǒng)計(jì)學(xué)意義�！窘Y(jié)論】球囊擴(kuò)張式支架治療癥狀性頸總動脈弓上開口狹窄是一種有效、安全的方法,并發(fā)癥發(fā)生率低和近期效果好。
[Abstract]:[objective] to investigate the efficacy and safety of balloon dilated stents in the treatment of symptomatic stenosis of the superior carotid arch. [methods] Transcraniocerebral CT angiography (CTAA) or cerebrovascular angiography (DSAs) proved to be severe at the beginning of vertebral artery.52 patients with severe stenosis of the superior arch of the common carotid artery were treated with endovascular stenting.There were 34 males and 18 females, aged 52 years or 79 years, with an average age of 65.39 鹵8.97 years.Before operation, routine biochemical examination, CT or MRII-CTA DSA were performed, and NIHSS scores were evaluated at admission and discharge. The degree of stenosis was evaluated by the method of North American symptomatic carotid endarterectomy test (NASCET) for the measurement of internal carotid artery stenosis.Under local anesthesia, the femoral artery was punctured with modified Seldinger technique, and the sheath was inserted into the artery sheath, which was fed into the balloon dilated stent along the 0.035inch microlead wire.The complications of perioperative period were observed. [results] Fifty-two patients with stenosis of superior carotid arch were implanted with 51 stents, the success rate was 98.08.The distal cerebral protective devices were not used during the operation.The complications in perioperative period were 5.77%, including 1 case of horizontal embolization of middle cerebral artery, 1 case of massive cerebral infarction, 2 cases of postoperative hyperperfusion syndrome and 1 case of failure of operation.The NIHSS score before and after operation was 6.21 鹵2.20 鹵2.25 鹵1.80 P 0.05, and the stenosis rate was 87.90% 鹵7.60% 鹵2.30% 鹵2.30%. The difference was statistically significant. [conclusion] the balloon dilated stent is an effective and safe method for the treatment of symptomatic stenosis of the superior carotid artery arch, with low complication rate and good short-term effect.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張永力;劉方軍;;全腦血管造影術(shù)中主動脈弓形態(tài)學(xué)的分析[J];中國腦血管病雜志;2011年02期

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本文編號：1749522