本文選題：頸動脈支架成形術(shù) + 癥狀性腦梗死�。� 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：【目的】總結(jié)和分析頸動脈支架成形術(shù)引起的癥狀性腦梗死的病因�！痉椒ā炕仡櫺苑治�2005年1月至2016年1月期間在廣西醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科行頸動脈支架成形術(shù)并出現(xiàn)癥狀性腦梗死(Symptomatic cerebral infarction,SCI)的病人。通過術(shù)后復(fù)查的腦血管造影及頭顱影響學(xué)檢查評估新發(fā)的腦梗死病灶及相關(guān)的責(zé)任血管,回顧頸動脈支架置入手術(shù)的術(shù)前準(zhǔn)備、手術(shù)操作過程,分析癥狀性腦梗死的產(chǎn)生原因�！窘Y(jié)果】2005年1月至2016年1月期間共有931例病人行頸動脈支架成形術(shù),其中術(shù)后發(fā)生癥狀性腦梗死共23例,約占全部頸動脈支架成形術(shù)病人的2.47%。根據(jù)發(fā)生梗死的責(zé)任血管,分為:(1)大腦中動脈供血區(qū)相關(guān)性腦梗死:20例;(2)大腦前動脈供血區(qū)相關(guān)性腦梗死:2例;(3)基底動脈供血區(qū)相關(guān)性腦梗死:1例。分析23例癥狀性腦梗死發(fā)生的病因:(1)血管內(nèi)不穩(wěn)定斑塊脫落、破潰9例;(2)術(shù)中操作不當(dāng)8例(3)抗血小板藥物不足或抗血小板藥物抵抗3例;(4)手術(shù)過程中長時間血管痙攣2例;(5)不明原因1例�！窘Y(jié)論】癥狀性腦梗死是CAS的并發(fā)癥之一,CAS術(shù)中SCI發(fā)生的最常見原因是血管內(nèi)不穩(wěn)定斑塊脫落、破潰,其次依次為術(shù)中操作不當(dāng)、抗血小板藥物不足或抗血小板藥物抵抗、術(shù)中長時間腦血管痙攣。還有部分為不明原因型。對CAS病人,積極進(jìn)行術(shù)前評估,術(shù)中謹(jǐn)慎操作,術(shù)后規(guī)范用藥,減少SCI的發(fā)生率。
[Abstract]:[objective] to summarize and analyze the etiology of symptomatic cerebral infarction caused by carotid stenting. [methods] the cervical movement was performed in the Department of Neurology, the first affiliated Hospital of Guangxi Medical University from January 2005 to January 2016. Vein stent angioplasty with symptomatic cerebral infarction (SCI). To evaluate the new cerebral infarction focus and related responsible blood vessels by cerebrovascular angiography and cranial influence examination, and to review the preoperative preparation and operation process of carotid stent implantation. [results] from January 2005 to January 2016, 931 patients underwent carotid stenting, of which 23 had symptomatic cerebral infarction, accounting for 2.47% of the total carotid stenting. According to the responsible vessels of infarction, they were divided into 1: 1) middle cerebral artery supply area associated cerebral infarction (20 cases) cerebral infarction associated with anterior cerebral artery supply area (20 cases) anterior cerebral artery supply area associated cerebral infarction (2 cases) basilar artery supply area associated cerebral infarction (1 case). The etiology of 23 cases of symptomatic cerebral infarction was analyzed. 9 cases with ulceration were improperly operated in 8 cases (3 cases) lack of antiplatelet drugs or 3 cases with anti-platelet drug resistance (3 cases), 2 cases with long term vasospasm during operation, 1 case with unknown cause. [conclusion] symptomatic cerebral infarction is associated with CAS. One of the most common causes of SCI during CAS is the removal of unstable plaque in the blood vessel. Breakdown followed by improper operation, insufficient antiplatelet drugs or anti-platelet drug resistance, and long time cerebral vasospasm during operation. Some of them are of unknown origin. In order to reduce the incidence of SCI, CAS patients should be evaluated before operation, carefully operated during operation and standardized after operation.
【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8條

1 高峰;徐安定;;急性缺血性卒中血管內(nèi)治療中國指南2015[J];中國卒中雜志;2015年07期

2 郭德江;梁永平;李寶民;;血栓彈力圖在顱內(nèi)外動脈狹窄支架成形術(shù)前抗血小板聚集監(jiān)測中的應(yīng)用[J];解放軍醫(yī)學(xué)院學(xué)報;2015年06期

3 高鵬;焦力群;趙振偉;于嘉;蔡藝靈;崔永強(qiáng);王貴平;李天曉;賀迎坤;吳偉;尹森;史懷璋;鄭秉杰;何偉文;姜順婷;尹龍;魏銘;黃勝平;白小欣;王大明;劉加春;祁鵬;凌鋒;;癥狀性顱內(nèi)動脈狹窄不同療法的多中心隨機(jī)對照研究設(shè)計方案[J];中國腦血管病雜志;2014年06期

4 ;中國急性缺血性腦卒中診治指南2010[J];中華神經(jīng)科雜志;2010年02期

5 宋桂芹;王擁軍;董可輝;高培毅;;高分辨磁共振成像評價頸動脈粥樣硬化斑塊成分[J];中華老年心腦血管病雜志;2009年08期

6 馬寧;杜彬;姜衛(wèi)劍;;頸動脈支架成形術(shù)中栓子保護(hù)裝置應(yīng)用的研究進(jìn)展[J];中國卒中雜志;2007年05期

7 饒明俐;;《中國腦血管病防治指南》摘要(三)[J];中風(fēng)與神經(jīng)疾病雜志;2006年01期

8 姜衛(wèi)劍,杜彬,王擁軍,王素香,王桂紅,金e，

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