颈动脉分叉处支架置入术后严重持续性低血压的危险因素

doi:10.6040/j.issn.1671-7554.0.2023.0067

摘要/Abstract

摘要： 目的分析颈动脉分叉处支架置入术后严重持续性低血压的危险因素。方法回顾性分析2014年10月至2022年4月山东第一医科大学第一附属医院神经内科177例(181处病变)颈动脉分叉处狭窄并接受支架置入术患者术后严重持续性低血压的危险因素。采用单因素和多因素 Logistic 回归法分析术后严重持续性低血压的危险因素。结果 177例患者术后严重持续性低血压的发生率为53.1%。单因素分析显示,支架直径较大、术中应用阿托品、球囊扩张直径>5 mm、偏心狭窄和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的危险因素。多因素分析显示,术中应用阿托品、球囊扩张直径>5 mm和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的独立危险因素。结论颈动脉分叉处支架置入术后发生血流动力学损害是常见的并发症,术中应用阿托品、球囊扩张直径>5 mm和狭窄程度较重是颈动脉分叉处支架置入术后严重持续性低血压的独立危险因素。

关键词: 颈动脉分叉处狭窄, 支架, 低血压, 危险因素

Abstract: Objective To analyze the risk factors of severe persistent hypotension after carotid artery bifurcation stenting. Methods Clinical data of 177 patients(181 lesions)with carotid artery bifurcation stenosis who underwent stenting during Oct. 2014 and Apr. 2022 were retrospectively analyzed. The risk factors for postoperative severe persistent hypotension were analyzed with univariate and multivariate Logistic regression models. Results The incidence of severe persistent hypotension was 53.1%. Univariate analysis showed that large stent diameter, intraoperative use of atropine, balloon dilation diameter >5 mm, eccentric stenosis and severe stenosis were risk factors of severe persistent hypotension. Multivariate analysis indicated that intraoperative use of atropine, balloon dilation diameter >5 mm and severe stenosis were independent risk factors. Conclusions Hemodynamic impairment is a common complication after carotid artery bifurcation stenting. Intraoperative use of atropine, balloon dilation diameter > 5mm and severe stenosis are independent risk factors of severe persistent hypotension.

Key words: Carotid artery bifurcation stenosis, Stent, Hypotension, Risk factor

中图分类号:

R574

曲永强,赵泽宇,吴兴原,韩玮,段瑞生,李衍滨,李亨. 颈动脉分叉处支架置入术后严重持续性低血压的危险因素[J]. 山东大学学报 (医学版), 2023, 61(7): 78-82.

QU Yongqiang, ZHAO Zeyu, WU Xingyuan, HAN Wei, DUAN Ruisheng, LI Yanbin, LI Heng. Risk factors of severe persistent hypotension after carotid artery bifurcation stenting[J]. Journal of Shandong University (Health Sciences), 2023, 61(7): 78-82.

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