老年重度颈动脉狭窄血管成形术中球囊预扩的价值

摘要

目的 探讨球囊预扩在老年重度颈动脉狭窄血管成形术中的应用价值.方法 回顾性分析东莞市人民医院神经内科2010-01—2016-12收治的76例老年重度颈动脉狭窄患者,所有患者均行血管成形术,根据是否采用小球囊预扩分为球囊预扩组和非球囊预扩组,比较2组患者手术前后血管狭窄率和NIHSS评分及并发症发生率.结果 2组患者手术前后血管狭窄率差异均无统计学意义(χ2=0.937,P>0.05,χ2=2.016,P>0.05);手术前2组患者NIHSS评分差异无统计学意义(t=0.881,P>0.05),手术后2周球囊预扩组患者NIHSS评分(2.5±2.1)低于非球囊预扩组,差异有统计学意义(t=7.318,P<0.05).2组患者缺血性脑卒中的发生率无统计学差异(χ2=2.831、2.336,P>0.05),而球囊预扩组患者血管痉挛、迷走神经反射和高灌注损伤等并发症发生率均低于非球囊预扩组,差异有统计学意义(χ2=8.562、8.562、6.777,P<0.05).结论 老年重度颈动脉狭窄血管成形术中进行球囊预扩有助于降低患者术后2周NIHSS评分和术后并发症的发生率,值得在临床推广应用.%Objective To evaluate the value of balloon dilation in angioplasty for elderly patients with severe carotid steno-sis.Methods 76 cases of elderly patients with severe carotid artery stenosis in Dongguan People's Hospital from January 2010 to December 2016 were retrospectively analyzed.All patients underwent angioplasty and divided into balloon pre-dilation group and non-balloon pre-dilation group.The vascular stenosis rate,NIHSS score and complication rate before and after surgery in the two groups were compared.Results Two groups of patients had similar vascular stenosis rate(χ2 =0.937,P >0.05),postoperative vascular stenosis rate (χ2 =2.016,P >0.05)and preoperative NIHSS score(t =0.881,P >0.05).Two weeks after surgery,bal-loon pre-dilation group had lower NIHSS score than non-balloon pre-dilation group (t =7.318,P <0.05).Two groups had similar ischemic stroke incidence rate (χ2 =2.831,2.336,P >0.05).Balloon pre-dilation group had less occurrence of vascular spasm,va-gus reflex,high reperfusion injury and complication rates than non-balloon pre-dilation group (P <0.05).Conclusion In elderly patients with severe carotid stenosis angioplasty,balloon dilation can decrease the postoperative NIHSS score and reduce the inci-dence of postoperative complications at 2 weeks,it is worthy of clinical application.