本文選題：頸動脈狹窄 + 血管內(nèi)支架置入術(shù)��； 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]探討頸動脈狹窄患者支架置入術(shù)與認知功能改善的相關性,分析頸動脈支架置入影響頸動脈狹窄患者認知功能的機制,為今后頸動脈狹窄患者認知功能障礙的防治提供依據(jù)。[方法]1.收集2014年10月1日到2016年4月10日在昆明醫(yī)科大學第二附屬醫(yī)院神經(jīng)外科及腦血管病科住院的頸內(nèi)動脈狹窄患者36例。2.入院后對36例患者行頭顱MRI檢查或CT檢查及DSA檢查確診為頸內(nèi)動脈狹窄,狹窄程度50%為研究對象。收集患者的一般資料,包括性別、年齡、文化程度、吸煙史、飲酒史、高血壓病史、糖尿病史等。將36例患者分為頸動脈支架置入術(shù)治療組(23例)和對照組(13例),對照組以采用藥物保守治療為主。3.依據(jù)蒙特利爾認知評分量表(MoCA)對所有患者在治療前、治療后6個月、治療后12個月分別進行評分,計算出每位研究對象的量表總分及每個子項目的得分。4.采用SPSS17.0統(tǒng)計軟件分析所得數(shù)據(jù)。計數(shù)資料以相對數(shù)構(gòu)成比(%)表示,兩樣本間或組內(nèi)治療前后各項目評分均值比較采用χ2檢驗,計量資料以均數(shù)士標準差(χ ±s)表示,兩樣本均數(shù)間比較采用t檢驗,以P0. 05為差異有統(tǒng)計學意義。[結(jié)果] 1.治療組與對照組患者一般情況及相關血管危險因素比較,如年齡、性別、文化程度、吸煙史、高血壓病史、糖尿病史、高脂血癥等方面差異無統(tǒng)計學意義(P0. 05)。2.23例頸動脈支架置入術(shù)患者在治療后MoCA量表總分及視空間與執(zhí)行功能、注意力、延遲回憶力等項目均較治療前明顯改善,差異有統(tǒng)計學意義(P0.05),而13例僅藥物保守治療的對照組患者,治療前、治療后6個月、治療后12個月MoCA量表總分及各評分項目均改善不明顯,差異無統(tǒng)計學意義(P0. 05)。3.治療組與對照組患者比較,治療后6個月MoCA量表評分中治療組的總分及視空間與執(zhí)行功能、延遲回憶力較對照組改善明顯,差異有統(tǒng)計學意義(P0. 05),治療后12個月的總分及視空間與執(zhí)行功能、命名能力、注意力、延遲回憶力較對照組改善明顯,差異有統(tǒng)計學意義(P0. 05)。[結(jié)論]1.對于狹窄程度50%的頸動脈狹窄患者,頸動脈支架置入術(shù)能明顯改善患者的認知功能,尤其是視空間與執(zhí)行功能、注意力、延遲回憶力。2.頸動脈支架置入術(shù)患者較單純藥物保守治療患者能明顯改善認知功能,在治療后6個月在視空間與執(zhí)行功能、延遲回憶力方面改善明顯,治療后12個月在視空間與執(zhí)行功能、命名能力、注意力、延遲回憶力方面改善明顯。
[Abstract]:[objective] to investigate the correlation between stenting and cognitive function improvement in patients with carotid artery stenosis, and to analyze the mechanism of carotid stenting affecting cognitive function in patients with carotid artery stenosis. To provide evidence for the prevention and treatment of cognitive dysfunction in patients with carotid artery stenosis. [methods] 1. From October 1, 2014 to April 10, 2016, 36 patients with internal carotid artery stenosis in Department of Neurosurgery and Cerebrovascular Disease, second affiliated Hospital of Kunming Medical University, were collected. After admission, 36 patients were diagnosed as internal carotid artery stenosis by MRI or CT or DSA. The degree of stenosis was 50%. Collect general data of patients, including gender, age, education, smoking history, alcohol history, hypertension history, diabetes history, etc. Thirty-six patients were divided into two groups: the carotid stenting group (n = 23) and the control group (n = 13). According to the Montreal Cognitive scale (MOCA), all the patients were scored before treatment, 6 months after treatment and 12 months after treatment. The total score of each study object and the score of each sub-item were calculated. The data were analyzed by SPSS17.0 software. The counting data were expressed as relative number composition ratio. 蠂 2 test was used to compare the mean scores of each item before and after treatment between the two samples or within the group. The measured data were expressed as the mean standard deviation (蠂 鹵s), the mean values of the two samples were compared with t test and P0 respectively. The difference was statistically significant. [result] 1. There was no significant difference between the treatment group and the control group in general condition and related vascular risk factors, such as age, sex, education level, smoking history, hypertension history, diabetes history, hyperlipidemia and so on. After treatment, the total score of MoCA scale, visual space and executive function, attention and delayed recall were significantly improved in patients with carotid stenting. The difference was statistically significant (P 0.05), but there was no significant improvement in the total scores and scores of MoCA scale before treatment, 6 months after treatment and 12 months after treatment in 13 cases of control group treated only with conservative drug therapy, and there was no significant difference between them (P 0. 0). 05. 3. Compared with the control group, the total score, visual space and executive function of the treatment group were significantly improved compared with the control group in the MoCA scale score 6 months after treatment, and the difference was statistically significant (P0). The total score, visual space and executive function, naming ability, attention and delayed recall were significantly improved in 12 months after treatment compared with control group (P 0. 0). 05. [conclusion] 1. For 50% of patients with carotid artery stenosis, carotid stenting can significantly improve cognitive function, especially visual space and executive function, attention, delayed recall. The cognitive function of the patients treated with carotid artery stenting was significantly improved than that of the patients treated with conservative drug therapy, the visual space and executive function were significantly improved at 6 months after treatment, the delayed recall was significantly improved, and the visual space and executive function were improved 12 months after treatment. Naming ability, attention, and delayed recall improved significantly.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3

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