颈动脉狭窄支架成形术与内科治疗的疗效观察

目的:比较血管内支架成形术与内科药物治疗对颈动脉狭窄的疗效.方法:符合入选标准的131例颈动脉狭窄患者根据其经济承受能力及自愿原则,分为支架成形术治疗组71例和内科药物治疗对照组60例.两组患者1周,1个月,3个月,6个月,12个月定期随访.随访期间的卒中复发率、病死率及TIA发生率;美国国立卫生院卒中量表(NIHSS)神经功能缺损评分;改良Rankin评分(mRS).结果:支架成形组有1例(1.41%)发生原狭窄动脉供血区的轻微卒中,内科治疗组5例发生脑梗死,2例发生TIA(11.67%)(P<0.01);NIHSS、mRS评分提示支架成形治疗组患者的神经功能恢复和残疾程度改善优于内科治疗组(P<0.01).结论:血管内支架成形术治疗颈动脉狭窄是安全的、可行的,其疗效优于内科保守治疗.

Therapeutic effects between stent assisted angioplasty and medical treatment on patients with carotid artery stenosis

Objective：To compare the effectiveness between the stent asssisted angioplasty and medical treatment on patients with carotid artery stenosis.Methods：According to economic status and voluntary principle 131 patients who met selection criterion were divided into stent assisted angioplasty group including 71 patients and medication group including 60 patients.Follow-up was given before treatment and 1 week,1 month,3 month,6 month,12 month after treatment. Medical records collected included：（1）Recurrence and morbidity and TIA during the period of follow-ups;（2）NIHSS scale;（3）Modified ranking scale （mRS）. Results：1 case in stent asssisted angioplasty group occured slight stroke located in blood-supply area of original stenotic artery （1.41%%） and 5 happened stroke again and 2 happened TIA in medication group （11.67%）（P0.01）. Significant differences were shown between the two groups in NIHSS and mRS（P0.01）.A comparison to NIHSS and mRS between two groups showed the neural function of the stent assisted angioplasty group was better than that of medication group. Conclusion：The stent asssisted angioplasty is a safe,feasible therapy for carotid artery stenosis,which has a significant advantage over medical therapy.