發(fā)布時間：2018-02-09 21:15

  本文關鍵詞： 頸動脈支架 血流動力學 影響因素　出處：《蘇州大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:探討頸內動脈支架植入術(CAS)患者血流動力學改變的影響因素。方法:采用回顧性分析的方法收集接受頸內動脈支架植入術(CAS)患者的臨床資料,使用統計學方法分析影響血流動力學不穩(wěn)定(HI)和持續(xù)性血流動力學不穩(wěn)定(PHI)的相關因素,并隨訪發(fā)生PHI的患者,研究CAS對血壓的遠期影響。結果:根據入組標準,有60例患者接受CAS,共有33例發(fā)生了HI,有16例持續(xù)時間大于6小時。10例患者接受多巴胺等升壓藥物治療。根據單因素分析,飲酒(p=0.047),偏心性狹窄(p=0.001),病變距離分叉長度(p=0.009)為HI發(fā)生的相關因素,根據多因素回顧分析,偏心性狹窄(p=0.006),病變距離分叉長度(p=0.026)為HI的獨立因素。同時,偏心性狹窄(p=0.006)也為PHI的獨立危險因素。隨訪了10例發(fā)生PHI的患者6個月后血壓、心率的變化情況,與上述患者術后48小時的收縮壓、心率進行對比后,發(fā)現其收縮壓平均增長16.333mmHg,心率平均增長5.8次/分。所有患者在1年后血壓達到正常范圍。結論:CAS患者術后血液動力學改變與飲酒,偏心性狹窄,病變到分叉的距離諸因素相關。根據患者的臨床基本情況與病情特點對患者術前進行積極干預可以有效的降低HI的發(fā)生,改善患者的預后。CAS對患者遠期血流動力學的改變不明顯。
[Abstract]:Objective: to investigate the influencing factors of hemodynamic changes in patients undergoing internal carotid artery stenting (CAS). Methods: the clinical data of patients undergoing internal carotid stenting (CAS) were collected by retrospective analysis. The factors related to hemodynamic instability (HI) and persistent hemodynamic instability (PHI) were analyzed by statistical method. Patients with PHI were followed up to study the long-term effects of CAS on blood pressure. There were 60 patients who received CAS, 33 patients who had HIS, 16 patients who had duration longer than 6 hours, 10 patients who were treated with dopamine and other blood pressure drugs, according to univariate analysis. Drinking p0. 047, eccentric stenosis, p0. 001, and distance of lesion distance) were the related factors of HI. According to the retrospective analysis of many factors, eccentricity stenosis (p0. 006) and distance of lesion (p0. 026) were independent factors of HI. 10 patients with PHI were followed up for 6 months. The changes of blood pressure and heart rate were compared with the systolic blood pressure and heart rate of 48 hours after operation. It was found that the systolic blood pressure increased 16.333mm Hgand the heart rate increased 5.8 times per minute. The blood pressure of all patients reached normal range after one year. The distance between lesion and bifurcation is related to many factors. According to the basic clinical situation and the characteristics of the patient's condition, the positive intervention before operation can effectively reduce the occurrence of HI. No significant changes in long-term hemodynamics were observed by improving prognosis. CAS.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R743.3

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