自膨式颈动脉支架置入术围手术期低血流动力学的改变及治疗Change of hemodynamic depression and pharmaceutical therapy with self-expanding carotid artery stenting in perioperative period
李润雄,吴志强,陈仰昆,罗根培,王世芳,苗海锋
摘要(Abstract):
目的探讨自膨式颈动脉支架置入术围手术期低血流动力学的发生情况及药物治疗效果。方法回顾东莞市人民医院近1年多来自膨式颈动脉支架置入术13例患者的临床资料,血流动力学损害者定义为:收缩压<90 mm Hg和(或)平均动脉压<50 mm Hg,或心率<60次/min。结果术中、术后出现低血流动力学状况并需要使用阿托品的患者分别为5例,2例,术中、术后需要使用多巴胺分别为6例,3例,均未发生永久神经系统或其他系统并发症,部分患者球囊扩张时心率及血压改变最为明显,术中和术后多巴胺使用剂量及持续时间有较大个体差异。结论自膨式颈动脉支架置入术围手术期低血流动力学的改变需要严密观察,通过阿托品及多巴胺可以得到有效控制,并可防止相应并发症的发生。
关键词(KeyWords): 颈动脉狭窄;支架;低血压;药物疗法
基金项目(Foundation): 东莞市科技局基金项目(201010515000076)
作者(Author): 李润雄,吴志强,陈仰昆,罗根培,王世芳,苗海锋
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