缺血性脑血管病患者应用颈动脉支架成形术治疗的临床效果分析

摘要

目的总结颈动脉狭窄支架成形术的经验，评价其疗效。方法根据患者临床治疗方式的不同，将本院收治的92例颈动脉狭窄患者分为两组，即支架成形术治疗组（46例），单纯药物治疗组（46例）。药物组患者行单纯药物治疗，即予以患者氯吡格雷、阿司匹林及阿托伐他汀长期维持治疗。支架成形术治疗组患者行颈动脉支架成形术（carotid artery stenting，CAS）治疗。观察支架释放成功率；治疗1个月后，分别对两组患者的颈动脉狭窄程度进行评价；同时观察并统计两组患者治疗后并发症的发生率及死亡率。另外，观察支架成形术治疗组患者支架置入后的生物相容性及不良反应发生情况。结果支架成形术治疗组支架释放成功率为100%，患者治疗后颈动脉重度狭窄的比率为2.18%，单纯药物治疗组为21.74%。两组比较，差异具有显著性（P＜0.01）。治疗后，支架成形术治疗组患者颈动脉短暂性脑缺血发作（TIA）、缺血性脑卒中、新发梗死及死亡的发生率依次为0、2.18%、2.18%、0；单纯药物治疗组依次为10.87%、6.52%、4.35%、6.52%。两组比较，差异具有显著性（P＜0.05）。支架成形术治疗组患者无特殊生物相容性反应，术后不良反应的总发生率为10.87%。结论支架成形术能有效改善患者颈动脉狭窄程度，并降低患者颈动脉TIA、缺血性脑卒中、新发梗死及死亡的发生率。%Objective To summarize the experience of carotid artery stenosis stent angioplasty, and evaluate its curative effect. Methods According to the different clinical treatment, our hospital 92 cases of patients with carotid stenosis was divided into two groups, namely, stent angioplasty treatment group 46 cases, 46 cases of simple drug treatment group. Drug group of patients with simple drug treatment, shall be, thanks to aspirin and clopidogrel in patients with long-term maintenance treatment lipitor. Patients with carotid artery stent plasty group carotid stenting (carotid artery stenting, CAS) treatment. Observation stents release rate;1 month after treatment, respectively on two groups patients of carotid stenosis degree evaluation;at the same time observation and statistics of two groups after treatment in patients with the incidence of complications and mortality. In addition, observe the biocompatibility of the observation group of patients after stent implantation and adverse reactions occur. Results Stents forming group released the success rate was 100%, the ratio of carotid artery after treatment in patients with severe stenosis was 2.18%, and the drug group was 21.74%. Comparison of two groups, the difference is signiifcant (P<0.01). Group therapy, stent angioplasty in patients with carotid TIA and ischemic stroke, new hair infarction and the incidence of death in 0, 2.18%, 2.18%, 0;Drug group was 10.87%, 6.52%, 4.35%and 6.52%in turn. Comparison of two groups, the difference is statistically signiifcant (P<0.05). Stent angioplasty patients no special biocompatibility reaction, after surgery, the total incidence of adverse reactions was 10.87%. Conclusion The stent plasty can effectively improve the patient's degree of carotid stenosis, and reduce the patients with carotid TIA and ischemic stroke, new hair infarction and the incidence of death.