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医学临床研究  2021, Vol. 38 Issue (6): 906-908    DOI: 10.3969/j.issn.1671-7171.2021.06.029
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行支架植入术治疗的脑血管狭窄患者围术期缺血性脑卒中发生的危险因素分析
杜方雷1, 曹宏斌2*
1.榆林市第二医院,陕西 榆林 719000;
2.神木市医院神经外科,陕西 榆林 719300
Analysis of Risk Factors of Perioperative Ischemic Stroke in Patients with Cerebrovascular Stenosis Treated by Stent Implantation
DU Fang-lei, CAO Hong-bin
Yulin NO.2 Hospital,Yulin 719000
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摘要 【目的】探讨行支架植入术治疗的脑血管狭窄患者围术期缺血性脑卒中发生的危险因素。【方法】回顾性分析2015年5月至2019年5月于本院收治的160例行支架植入术治疗的脑血管狭窄患者临床资料,根据围术期缺血性脑卒中发生情况将其分为非卒中组(n=139)和卒中组(n=21)。记录两组患者一般资料及手术前后美国国立卫生研究院卒中量表(NIHSS)、治疗前后血管活性药物使用情况、手术前后影像检查、术前1 d上午以及下午收缩压(SBP)的平均值、心率(HR)最慢值等。采用Logistic多因素分析围术期缺血性脑卒中发生的危险因素。【结果】160例患者支架植入术后发生缺血性脑卒中21例(13.13%)。两组患者的平均年龄、入院前抗血小板药物、钙化斑块、术前合并未治疗的血管狭窄、术中HR最慢值<60次/分钟比较,差异有统计学意义(P<0.05)。年龄增高、钙化斑块及术前合并未治疗的血管狭窄是支架植入术脑血管狭窄患者发生围术期缺血性脑卒中的独立危险因素(P<0.001),入院前抗血小板药物使用及术中HR最慢值<60次/分钟为保护因素(P<0.001)。【结论】年龄越大、钙化斑块及术前合并未治疗的血管狭窄是支架植入术脑血管狭窄患者围术期缺血性脑卒中发生的独立危险因素,在术前应根据患者个体差异制定出安全性较高的手术治疗方案。
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杜方雷
曹宏斌
关键词 脑缺血/诊断卒中支架手术期间危险因素    
Abstract:【Objective】To investigate the risk factors of perioperative ischemic stroke in patients with cerebrovascular stenosis treated by stent implantation. 【Methods】The clinical data of 160 patients with cerebrovascular stenosis treated by stent implantation in our hospital from May 2015 to may 2019 were retrospectively analyzed. According to the occurrence of perioperative ischemic stroke, they were divided into non stroke group (n=139) and stroke group (n=21). The general information, NIHSS before and after operation, the use of vasoactive drugs before and after treatment, imaging examination before and after operation, the mean value of systolic blood pressure (SBP) in the morning and afternoon 1 day before operation, and the slowest value of heart rate (HR) were recorded. Logistic multivariate analysis was used to analyze the risk factors of perioperative ischemic stroke.【Results】 Among 160 patients, 21 (13.13%) had ischemic stroke after stent implantation. There were significant differences between the two groups in average age, antiplatelet drugs before admission, calcified plaque, preoperative combined with untreated vascular stenosis, and the slowest HR < 60 beats/min (P<0.05). Increased age, calcified plaque and preoperative combined with untreated vascular stenosis were independent risk factors for perioperative ischemic stroke in patients with stent implantation cerebral vascular stenosis (P<0.001). The use of antiplatelet drugs before admission and the slowest HR value during operation were protective factors (P<0.001). 【Conclusion】The older age, calcified plaque and preoperative combined with untreated vascular stenosis are independent risk factors of perioperative ischemic stroke in patients with stent implantation cerebral vascular stenosis, and a safe surgical treatment plan should be formulated according to individual differences of patients before operation.
Key wordsBrain Ischemia /DI    Stroke    Stents    Intraoperative Period    Risk Factors
收稿日期: 2020-10-14     
中图分类号:  R972.6  
通讯作者: *E-mail:1974700526@qq.com   
引用本文:   
杜方雷, 曹宏斌. 行支架植入术治疗的脑血管狭窄患者围术期缺血性脑卒中发生的危险因素分析[J]. 医学临床研究, 2021, 38(6): 906-908.
DU Fang-lei, CAO Hong-bin. Analysis of Risk Factors of Perioperative Ischemic Stroke in Patients with Cerebrovascular Stenosis Treated by Stent Implantation. JOURNAL OF CLINICAL RESEARCH, 2021, 38(6): 906-908.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.06.029     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I6/906
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