段鸿洲,李良,张扬,伊志强,张家湧,陈明,刘兆平,李建平,鲍圣德

• 1:北京大学第一医院神经外科
• 2:北京大学第一医院心内科

摘要(Abstract)：

目的探讨分期介入治疗颈动脉狭窄合并冠心病患者的疗效,并发症及随访效果。方法回顾性分析了57例经冠状动脉及脑血管造影或CT血管成像(CTA)证实的颈动脉狭窄合并冠心病患者的临床资料,所有患者均先行经皮冠状动脉介入治疗(PCI),术后1周左右再行颈动脉支架术(CAS),手术前后均进行水化以保护肾功能,观察手术前后患者的神经功能评分(mRS)、肾功能,术中术后并发症等,对患者进行长期随访,观察有无心肌梗死、脑梗死并复查造影观察支架内情况。结果 57例患者均成功行分期介入手术,技术成功率100%,术中显示血管通畅,狭窄解除满意,手术前后患者mRS评分无明显变化,两次介入前后估算的肾小球滤过率无明显变化,1例患者PCI术后3d出现原脑梗症状加重,紧急行CAS术,预后良好。虽有16例患者存在颈动脉窦反射,但所有患者术后均未出现心肌梗死、脑梗死,无死亡患者。随访期间无一例患者出现心肌梗死及支架侧脑梗死。结论对于颈动脉狭窄合并冠心病患者,分期先行PCI后行CAS是安全有效的治疗方式。

关键词(KeyWords)： 颈动脉狭窄;冠状动脉疾病;血管成形术

Abstract:

Keywords:

基金项目(Foundation): 教育部高等学校博士点基金(20110001120050)

作者(Author): 段鸿洲,李良,张扬,伊志强,张家湧,陈明,刘兆平,李建平,鲍圣德

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