颈动脉支架成形术中血液动力学的变化及其对策

目的:观察颈动脉支架成形术中血液动力学不稳定的发生率及其相关因素。方法:15例症状性颈动脉狭 窄患者在行血管内支架成形术时,观察其血压、心率的变化以及药物控制的疗效、围手术期有无并发症。结果:15例支 架放置全部成功,其中11例在进行颈动脉分叉部球囊扩张或支架释放时出现不同程度的心率减慢和血压下降,6例出 现颈动脉窦反应,在使用阿托品和多巴胺后均恢复正常。术中及术后无与血液动力学相关的脑低灌注或高灌注并发症。 结论:血液动力学不稳定是CAS中较为常见的并发症,可通过药物加以控制。

Hemodynamic changes during cai'otid angioplasty and stenting and its countermeasures

Objective: To determine the frequency and relevant factors of hemodynamic instability during carotid angioplasty and stenting. Methods: Fifteen patients with symptomatic carotid artery stenosis were treated with carotid angioplasty and stenting (CAS). The changes of blood pressure (BP), heart rate (HR) and complications during the perioperation were recorded, and therapeutic effectes on hemodynamic instability were assessed. Results: All carotid stents were successfully implanted on the first procedure without complications in all 15 patients. Bradycardia and hypotension of various degrees occurred inl 1 patients during manipulations of the carotid bifurcation. Carotid sinus reactions developed in 6 patients. The decreased BP and HR were returned to baseline after the treatment of dopamine or atropine. There was no hypoperfusion or hyperperfusion complications correlated with hemodynamics. Conclusion : Hemodynamic instability is a frequent event during carotid angioplasty and stenting, and can be treated effectively by intravenous application of drugs.