脑保护装置下老年重度颈动脉狭窄患者颈动脉支架成形术的有效性及安全性分析.docVIP

脑保护装置下老年重度颈动脉狭窄患者颈动脉支架成形术的有效性及安全性分析 　　【摘要】 目的：对老年重度颈动脉狭窄患者，在脑保护装置（CPD）下行颈动脉支架成形术（CAS）有效性及安全性进行分析与探讨。方法：选取2011年9月-2015年4月本院收治老年重度颈动脉狭窄需进行颈动脉支架成形术患者84例，并按照随机数字表法分为试验组与对照组，每组42例。对照组行常规颈动脉支架成形术，试验组在脑保护装置下，行颈动脉支架成形术。比较两组患者CAS术后血管狭窄程度、NFA评分、Barthel指数、脑缺血以及脑卒中发生率。结果：试验组患者术后血管狭窄程度（19.96±3.22）%，NFA评分（14.09±3.25）分，Barthel指数（47.56±3.11）分，脑缺血发生率2.38%，脑卒中发生率0，对照组分别为（22.27±3.41）%、（17.89±5.42）分、（33.37±2.49）分、26.19%、14.29%，两组比较差异均有统计学意义（P0.05）。结论：在CPD保护下进行CAS手术，患者术后神经功能及日常生活能力等评分明显提高，患者复发情况较少，临床疗效安全显著，有助于患者术后恢复。 　　【关键词】 老年； 脑保护装置； 颈动脉支架成形术； 重度颈动脉狭窄 　　【Abstract】 Objective： To analyze the effect and safety of carotid stenting （CPD） in patients with severe carotid stenosis， and investigate the effect and safety of carotid stenting （CAS）. Method： From September 2011 to April 2015， 84 patients with severe carotid stenosis in our hospital were treated with carotid stenting， and divided into experimental group and control group， 42 cases in each group. The control group was treated with routine carotid stenting， and the experimental group was treated with carotid stenting. The vascular stenosis， NFA score， Barthel score， CAS index， cerebral ischemia and stroke incidence were compared between the two groups.Result： In the experimental group， the postoperative blood vessel stenosis was （19.96±3.22）%， NFA score was（14.09±3.25）points， Barthel index was （47.56±3.11）points， cerebral ischemia occurrence rate was 2.38%， and stroke incidence rate was 0， which were better than （22.27±3.41）%， （17.89±5.42）points， （33.37±24.49）points， 26.19%， and 14.29% of the control group， with statistically differences （P0.05）. Conclusion： CAS operation in the protection of CPD， can improve postoperative neurological function and daily life ability score significantly，patients are with less recurrence，it can significantly improve clinical efficacy and safety in patients with postoperative recovery. 　　【Key words】 Old age； Protective device； Carotid artery stenting； Severe carotid stenosis 　　First-author’s a