摘要
目的探讨数字减影血管造影(DSA)在缺血性脑卒中患者颈部血管狭窄诊断及治疗中的价值。方法回顾性分析2020年1月至2022年6月泗县人民医院收治的260例缺血性脑卒中颈部血管狭窄患者的临床资料,所有患者均进行CT血管成像(CTA)与DSA检查。根据DSA检查结果给予患者介入手术治疗或药物治疗,根据患者是否进行介入治疗将其分为介入组204例和非介入组56例,分析DSA在缺血性脑卒中患者颈部血管狭窄诊断及治疗中的价值。结果DSA的病变例数与病变血管检出率均较CTA升高(均P<0.05)。前循环梗死中以颈动脉起始部较为多见,后循环梗死中以椎底动脉颅内段较为多见,前循环短暂性脑缺血发作中以锁骨下动脉起始部与颈内动脉颅内段及大脑中动脉较为多见,后循环短暂性脑缺血发作中以椎动脉起始部、颈内动脉颅内段及大脑中动脉、椎底动脉颅内段较为多见(均P<0.05)。介入组卒中复发率、残疾率、死亡率均较非介入组降低(均P<0.05)。结论DSA在缺血性脑卒中患者颈部血管狭窄中具有较高的诊断价值,同时对介入手术治疗提供较高的参考价值,且经手术治疗后,患者的临床结局较好,可有效降低患者颈部血管的狭窄率,减轻患者的神经功能损害。
Objective To assess the application of digital subtraction angiography(DSA)in the diagnosis of cervical stenosis in patients with ischemic stroke.Methods The clinical data of 260 patients with ischemic stroke and cervical stenosis admitted in Sixian County People's Hospital from January 2020 to June 2022 were retrospectively analyzed.All patients underwent CT angiography(CTA)and DSA examinations.According to the results of DSA examination,204 patients were given interventional therapy(interventional group)and 56 patients were given drug therapy(non-interventional group).Value in the diagnosis and treatment of peripheral vascular stenosis.Results The number of lesions and the detection rate of diseased vessels in DSA were higher than those in CTA(all P<0.05).The anterior circulation infarction was more common in the origin of the carotid artery,the posterior circulation infarction was more common in intracranial segment of the vertebral basilar artery.The anterior circulation transient ischemic attack was more common in the origin of the subclavian artery and the internal carotid artery,while the posterior circulation transient ischemic attack was more common in the internal segment and middle cerebral artery,the origin of the vertebral artery,the intracranial segment of the internal carotid artery,the middle cerebral artery and the intracranial segment of the vertebral basilar artery(all P<0.05).The stroke recurrence rate,disability rate and mortality rate in the intervention group were lower than those in the non-intervention group(all P<0.05).Conclusion DSA has diagnostic value for cervical stenosis and provides a reference for interventional procedure in ischemic stroke patients.The interventional therapy can reduce the stenosis of peripheral blood vessels and alleviate the neurological damage of patients.
作者
周瑞银
周强
ZHOU Ruiyin;ZHOU Qiang(Conduit Room,Sixian County People's Hospital,Suzhou 234300,China;不详)
出处
《浙江医学》
CAS
2023年第11期1198-1202,共5页
Zhejiang Medical Journal
