摘要
目的分析椎动脉起始部狭窄患者支架置入联合药物治疗与单纯药物治疗的临床疗效及安全性。方法选择2016年1月至2018年6月在广西壮族自治区梧州市工人医院治疗的112例椎动脉起始部狭窄患者,按随机数字表法分为药物组、支架+药物组,每组56例。药物组给予单纯药物治疗,支架+药物组给予支架置入联合药物治疗,观察两组治疗后12个月后循环缺血性事件发生率、血管狭窄改善情况和神经功能损伤改善情况。结果支架+药物组手术成功率为100.0%(56/56)。支架+药物组治疗后血管狭窄率低于药物组[(15.21±3.74)%比(18.62±4.27)%],但再狭窄率高于药物组[26.79%(15/56)比7.14%(4/56)],差异有统计学意义(P<0.05)。支架+药物组治疗后后循环缺血性事件总发生率低于药物组[8.93%(5/56)比28.57%(16/56)],差异有统计学意义(χ^(2)=7.092,P=0.008)。支架+药物组治疗后美国国立卫生研究院卒中量表、生命质量评分量表评分均低于药物组[(2.30±0.36)分比(3.75±0.52)分、(4.11±0.51)分比(6.14±0.57)分],差异均有统计学意义(P<0.05)。结论支架置入配合药物方案应用于椎动脉起始部狭窄患者治疗,可有效减轻患者神经功能损伤,提高总有效率,有助于患者生命质量改善,但支架内再狭窄发生率较高。
Objective To analyze the clinical efficacy and safety of stent implantation combined with drug therapy and drug therapy alone in patients with vertebral artery initial stenosis.Methods A total of 112 patients with vertebral artery initial stenosis who were treated in Wuzhou Workers′Hospital from January 2016 to June 2018 were selected and divided into drug group and stent+drug group according to random number table method,with 56 patients in each group.The drug group received drug therapy alone,and stent+drug group received stent implantation combined with drug therapy.The incidence of ischemic events in posterior circulation,the improvement of vascular stenosis rate and the improvement of neurological function injury were observed in the two groups after 12 months of treatment.Results The success rate in the stent+drug group was 100.0%(56/56).The rate of vascular stenosis in the stent+drug group was lower than that in the drug group:(15.21±3.74)%vs.(18.62±4.27)%;but the incidence of restenosis was higher than that in the drug group:26.79%(15/56)vs.7.14%(4/56),the differences were statistically significant(P<0.05).The total incidence of ischemic events in the posterior circulation after treatment in the stent+drug group was lower than that in the drug group:8.93%(5/56)vs.28.57%(16/56),and the difference was statistically significant(χ^(2)=7.092,P=0.008).After treatment,the National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(MRS)in the stent+drug group were lower than those in the drug group:(2.30±0.36)scores vs.(3.75±0.52)scores,(4.11±0.51)scores vs.(6.14±0.57)scores,and the differences were statistically significant(P<0.05).Conclusions The application of stent implantation combined with drug regimen in the treatment of patients with vertebral artery initial stenosis can effectively reduce the neurological damage of patients,andimprove the total effective rate,which is conductive to the improvement of patients′quality of life,but the rate of stent restenosis is high.
作者
张岐平
李育英
李海宁
梁炳松
饶源
陈小玲
李健
陈英道
Zhang Qiping;Li Yuying;Li Haining;Liang Bingsong;Rao Yuan;Chen Xiaoling;Li Jian;Chen Yingdao(Department of Neurology,Wuzhou Workers′Hospital,Guangxi Wuzhou 543001,China)
出处
《中国医师进修杂志》
2021年第10期898-901,共4页
Chinese Journal of Postgraduates of Medicine
基金
广西壮族自治区梧州市科学研究与技术开发计划项目(201702061)。
关键词
椎底动脉供血不足
支架
药物疗法
疗效比较研究
Vertebrobasilar insufficiency
Stents
Drug therapy
Comparative effectiveness research
