摘要
目的分析颈动脉支架成形术(carotid artery stent,CAS)后并发高血压脑出血(hypertensive cerebral hemor⁃rhage,HCH)的临床特点及相关因素。方法对2016年1月-2020年7月医院收治的793例行CAS患者的临床资料进行回顾性分析,统计CAS后HCH发生情况及临床特点,分析影响CAS后并发HCH的因素。结果CAS患者术后HCH的发生率为2.27%;CAS后并发HCH患者颈内动脉起始部重度狭窄,多发于壳核出血、丘脑出血,平均术后出血时间在(6.28±1.04)h,临床多表现为意识障碍、活动障碍,术后1周内16.67%患者出现死亡;多因素分析显示术前颈内动脉狭窄程度、术前颈内动脉血流速度、术前应用氧自由基清除剂是CAS后并发HCH的独立影响因素(P<0.05)。结论CAS后HCH发生率低,但死亡风险高,术前颈内动脉狭窄程度、术前颈内动脉血流速度、术前应用氧自由基清除剂是CAS后并发HCH的独立影响因素。
Objective To analyze the clinical characteristics and related factors of hypertensive cerebral hemorrhage(HCH)after carotid artery stenting(CAS).Methods The clinical data of 793 patients who had undergone CAS were ret‐rospectively analyzed.The occurrence rate of HCH after CAS were counted.The clinical characteristics of HCH were studied.The influencing factors were analyzed.Results The incidence of postoperative HCH in these CAS patients was 2.27%.Severe stenosis was found at the beginning of internal carotid artery in 18 cases of CAS complicated with HCH.The hemorrhage mostly occurred in putamen and thalamus with an average postoperative bleeding time of(6.28±1.04)h.The clinical manifestations included disturbances of consciousness and mobility.16.67%of the patients died within 1 week after surgery.Multivariate analysis showed that the degree of internal carotid artery stenosis,blood flow velocity of the internal carotid artery,and application of oxygen free radical scavengers before operation were independent influenc‐ing factors of HCH after CAS(P<0.05).Conclusion The incidence of HCH after CAS is low,but the risk of death is high.The degree of internal carotid artery stenosis,blood flow velocity of the internal carotid artery,and application of oxygen free radical scavengers before operation are independent factors affecting HCH after CAS.
作者
许济
田苗
陈斌
李花
XU Ji;TIAN Miao;CHEN Bin;LI Hua(3201st Hospital affiliated to Medical College of Xi'an Jiaotong University,Hanzhong Shanxi 723000,China.)
出处
《中国急救复苏与灾害医学杂志》
2021年第7期751-753,760,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
陕西省科技厅社发攻关项目(编号:2016SF-169)。
关键词
颈动脉支架成形术
高血压脑出血
相关因素
Carotid artery stent
Hypertensive cerebral hemorrhage
Relevant factors
