颈内动脉支架术后血流动力学改变与临床疗效的关系

摘要

Objective This paper aims to explore the relationship between hemodynamic changes and the clinical effect after the symptomatic PTAS ( Pervutaneous Transluminal Angioplasty and Stenting ). Methods Thirty-two cases of patients with symptomatic carotid stenosis after the PTAS are researched through the Color Doppler Flow Imaging ( CDFI ), and a comparative analysis of the changes of obligatory arterial flow indexes and the clinical curative effect ( the nih neural function defect scores, NIHSS ) are also conducted, in which the results are also comparable to the Digital Subtraction Angiography( DSA ). Results In this paper, the results can be obtained within one week after the angioplasty on the thirty-two cases concerned symptomatic PTAS, the stricture in spectrum of CDFI is almost close to a normal level. NIHSS scores are six points and two points before and after the operation respectively. Moderate and severe strictures in CDFI conform to DSA to the extent of 81. 8% and 84. 6% respectively. Conclusion From the analysis, the conclusion can be drawn that the changes of CDFI indexes are closely correlated to the improvement of the clinical signs and symptoms. Both DSA and CDFI can be the way to evaluate the changes of hemodynamic before and after PTAS.%目的 探讨症状性颈内动脉狭窄支架成形术(PTAS)前后血流动力学改变与临床疗效之间的关系.方法 通过彩色多普勒血流成像(CDFI)对32例症状性颈内动脉狭窄的患者行PTAS治疗前后责任动脉血流指标的变化及临床疗效(美国国立卫生院神经功能缺损评分,NIHSS)进行对比分析,并与数字减影血管造影术(DSA)结果进行比较.结果 32例症状性颈内动脉狭窄支架成形术后一周内,狭窄段的CDFI频普基本接近正常水平;术前、术后NIHSS评分分别为6分、2分;中、重度狭窄CDFI与DSA相符率分别为81.8%、84.6%.结论 CDFI指标的变化与临床症状体征的改善具有密切相关性;CDFI与DSA均可作为PTAS术前、术后血流动力学改变的评价手段.