本文關(guān)鍵詞： 頸動(dòng)脈支架 血流動(dòng)力學(xué) 影響因素　出處：《蘇州大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討頸內(nèi)動(dòng)脈支架植入術(shù)(CAS)患者血流動(dòng)力學(xué)改變的影響因素。方法:采用回顧性分析的方法收集接受頸內(nèi)動(dòng)脈支架植入術(shù)(CAS)患者的臨床資料,使用統(tǒng)計(jì)學(xué)方法分析影響血流動(dòng)力學(xué)不穩(wěn)定(HI)和持續(xù)性血流動(dòng)力學(xué)不穩(wěn)定(PHI)的相關(guān)因素,并隨訪發(fā)生PHI的患者,研究CAS對血壓的遠(yuǎn)期影響。結(jié)果:根據(jù)入組標(biāo)準(zhǔn),有60例患者接受CAS,共有33例發(fā)生了HI,有16例持續(xù)時(shí)間大于6小時(shí)。10例患者接受多巴胺等升壓藥物治療。根據(jù)單因素分析,飲酒(p=0.047),偏心性狹窄(p=0.001),病變距離分叉長度(p=0.009)為HI發(fā)生的相關(guān)因素,根據(jù)多因素回顧分析,偏心性狹窄(p=0.006),病變距離分叉長度(p=0.026)為HI的獨(dú)立因素。同時(shí),偏心性狹窄(p=0.006)也為PHI的獨(dú)立危險(xiǎn)因素。隨訪了10例發(fā)生PHI的患者6個(gè)月后血壓、心率的變化情況,與上述患者術(shù)后48小時(shí)的收縮壓、心率進(jìn)行對比后,發(fā)現(xiàn)其收縮壓平均增長16.333mmHg,心率平均增長5.8次/分。所有患者在1年后血壓達(dá)到正常范圍。結(jié)論:CAS患者術(shù)后血液動(dòng)力學(xué)改變與飲酒,偏心性狹窄,病變到分叉的距離諸因素相關(guān)。根據(jù)患者的臨床基本情況與病情特點(diǎn)對患者術(shù)前進(jìn)行積極干預(yù)可以有效的降低HI的發(fā)生,改善患者的預(yù)后。CAS對患者遠(yuǎn)期血流動(dòng)力學(xué)的改變不明顯。
[Abstract]:Objective: to investigate the influencing factors of hemodynamic changes in patients undergoing internal carotid artery stenting (CAS). Methods: the clinical data of patients undergoing internal carotid stenting (CAS) were collected by retrospective analysis. The factors related to hemodynamic instability (HI) and persistent hemodynamic instability (PHI) were analyzed by statistical method. Patients with PHI were followed up to study the long-term effects of CAS on blood pressure. There were 60 patients who received CAS, 33 patients who had HIS, 16 patients who had duration longer than 6 hours, 10 patients who were treated with dopamine and other blood pressure drugs, according to univariate analysis. Drinking p0. 047, eccentric stenosis, p0. 001, and distance of lesion distance) were the related factors of HI. According to the retrospective analysis of many factors, eccentricity stenosis (p0. 006) and distance of lesion (p0. 026) were independent factors of HI. 10 patients with PHI were followed up for 6 months. The changes of blood pressure and heart rate were compared with the systolic blood pressure and heart rate of 48 hours after operation. It was found that the systolic blood pressure increased 16.333mm Hgand the heart rate increased 5.8 times per minute. The blood pressure of all patients reached normal range after one year. The distance between lesion and bifurcation is related to many factors. According to the basic clinical situation and the characteristics of the patient's condition, the positive intervention before operation can effectively reduce the occurrence of HI. No significant changes in long-term hemodynamics were observed by improving prognosis. CAS.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R743.3

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