【摘要】：目的探討癥狀性大腦中動脈粥樣硬化性狹窄患者接受顱內支架植入術前后腦血流動力學變化。方法回顧成功實施顱內支架植入術的39例癥狀性大腦中動脈粥樣硬化性狹窄患者基線資料,對采用經顱多普勒超聲檢測術前、術后1周、術后3個月大腦中動脈狹窄段收縮期峰值流速(PSV)和脈動指數(shù)(PI)進行分析,比較手術前后病變血管血流動力學變化。結果 39例患者中1例術后狹窄改善不明顯,38例動脈平均管徑狹窄率由治療前(80.3±8.5)%改善為術后即刻(16.3±9.2)%(P=0.011)。術后1周、術后3個月大腦中動脈狹窄段PSV與術前比較有明顯降低(P=0.023),PI也較術前明顯降低(P=0.028)。術后3個月時2例患者平均PSV回復升高31%~39%;術后3個月與術后1周比較,平均PSV略有升高(P=0.129),PI稍有增高(P=0.115),但差異無統(tǒng)計學意義。結論癥狀性大腦中動脈粥樣硬化性狹窄患者接受顱內支架植入術后短期內腦血流得到有效增加,長期血流改善程度有待觀察。
[Abstract]:Objective to investigate the changes of cerebral hemodynamics before and after intracranial stenting in patients with symptomatic middle cerebral atherosclerotic stenosis. Methods the baseline data of 39 patients with symptomatic middle cerebral artery atherosclerotic stenosis who were successfully implanted with intracranial stents were reviewed. Transcranial Doppler ultrasound was used to detect the data before operation and 1 week after operation. The peak systolic velocity (PSV) and pulsation index (PI) of middle cerebral artery stenosis were analyzed 3 months after operation to compare the hemodynamic changes before and after operation. Results the mean arterial diameter stenosis rate of 38 patients was improved from (80.3 鹵8.5)% before treatment to (16.3 鹵9.2)% immediately after operation (P0. 011). 1 week after operation and 3 months after operation, the PSV of middle cerebral artery stenosis was significantly lower (P0. 023) and Pi was significantly lower than that of preoperative (P0. 028). At 3 months after operation, the average PSV of 2 patients was increased by 31 / 39, and the average PSV was slightly increased (P < 0. 129) and Pi was slightly higher than that of 1 week after operation (P = 0. 115), but there was no significant difference between the three months and one week after operation. Conclusion the cerebral blood flow in patients with symptomatic middle cerebral artery atherosclerotic stenosis after intracranial stenting can be effectively increased in a short period of time, and the improvement degree of long-term blood flow remains to be observed.
【作者單位】： 河南省安陽市人民醫(yī)院神經內科;鄭州大學人民醫(yī)院介入科;
【分類號】：R743.3

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