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目的观察颅内外血管狭窄支架成形术治疗对缺血性脑血管病(ICVD)的疗效及安全性。方法对35例ICVD患者进行颅内外血管内支架成形术,观察手术疗效。结果手术成功率97.14%(34例),其中6例患者(17.14%)发生围手术期并发症[短暂性脑缺血发作(TIA)3例,脑血管痉挛、术中低血压休克、术后低血压各1例],经治疗3 d内均完全恢复。22例脑梗死患者术后第15 d、30 d时的临床神经功能缺损评分与术前相比显著下降(均P<0.01)。术后随访2~13个月(1例失访),TIA患者1例于术后12个月死于脑干梗死,1例椎动脉支架术后4个月发生颈内动脉系统腔隙性脑梗死;2例患者发生斑秃。结论颅内外血管内支架成形术对防治ICVD安全、有效。
Objective To observe the efficacy and safety of intracranial and extravascular stenting in the treatment of ischemic cerebrovascular disease (ICVD). Methods Thirty-five ICVD patients underwent intracranial and intravascular angioplasty, and the curative effect was observed. Results The success rate of operation was 97.14% (34 cases). Perioperative complications occurred in 6 cases (17.14%) [three cases of transient ischemic attack (TIA), cerebral vasospasm, intraoperative hypotensive shock, postoperative 1 case of hypotension], all recovered within 3 days after treatment. The clinical neurological deficit scores of 22 patients with cerebral infarction at 15 and 30 days after operation were significantly lower than those before operation (all P <0.01). One case of TIA patients died of brainstem infarction at 12 months after operation and one case of lacunar artery of the internal carotid artery occurred at 4 months after operation Infarction occurred in 2 patients with alopecia areata. Conclusion Intracranial endovascular stent angioplasty is safe and effective in prevention and treatment of ICVD.