中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (34): 6413-6416.doi: 10.3969/j.issn.1673-8225.2010.34.035

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

脑血管支架材料学特征及置入后并发症

马明辉   

  1. 沈阳市第五人民医院神经内科(一病房)，辽宁省沈阳市    110023
  • 出版日期:2010-08-20 发布日期:2010-08-20
  • 作者简介:马明辉★，男，1981年生，辽宁省沈阳市人，汉族，在读硕士，医师，主要从事脑血管病的诊断及治疗。 mhyl2009@hotmail.com

Material characteristics of vascular stent and its complications after implantation

Ma Ming-hui   

  1. Department of Neurology (First Ward), Shenyang Fifth People’s Hospital, Shenyang   110023, Liaoning Province, China
  • Online:2010-08-20 Published:2010-08-20
  • About author:Ma Ming-hui★, Studying for master’s degree, Physician, Department of Neurology (First Ward), Shenyang Fifth People’s Hospital, Shenyang 110023, Liaoning Province, China mhyl2009@hotmail.com

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988

被引次数

10

摘要：

目的：探讨脑血管支架的材料学特性及其治疗脑血管疾病的应用效果，分析支架置入后并发症的发生原因。
方法：由第一作者采用电子检索的方式，在万方数据库(http://www.wanfangdata.com.cn/)及Pubmed数据库(http://www. ncbi.nlm.nih.gov/pubmed/)中检索有关脑血管支架材料学特征及其置入后并发症的研究文章，检索时间范围为1999-01/2009-12，关键词为“血管内支架，脑血管病，并发症”。共筛选纳入21篇文献进行评价。
结果：脑血管支架置入并发症主要有颈动脉窦反应、高灌注综合征、脑血管痉挛、血栓形成、再狭窄等。在各种脑血管支架中，金属支架易促进血栓的形成；聚合物支架与血管壁的相容性好于金属支架，可避免后期的内膜增殖；涂层支架可通过特殊涂覆技术包被于金属支架表面，抑制血小板的聚集；药物支架置入体内后，药物能够持续高浓度的释放，药物能够在“靶位”达到有效治疗浓度，能够有效预防支架内置入后的再狭窄。支架置入后并发症的发生虽然很难完全杜绝，但应尽量避免，要做到正确选择支架置入病例，提高操作者的熟练程度，纠正不良操作习惯，提高术者对并发症的认识和重视程度，严格围手术期的管理，对出现的并发症要及时正确处理避免产生严重后果。
结论：脑血管支架置入治疗可作为脑血管病的主要治疗方式之一，在治疗过程中，要根据临床症状不同，进行充足的置入准备，选择合适的支架类型，严格遵循适应证，避免出现并发症。

关键词: 脑血管支架, 脑血管病, 生物材料, 置入, 并发症

Abstract:

OBJECTIVE: To investigate the cerebral vascular stent material characteristics and its treatment of cerebral vascular disease, the application effect of stent complications causes.
METHODS: First author conducted an online retrieval of Wanfang database (http://www.wanfangdata.com.cn/) and Pubmed database (http://www. Ncbi.nlm.nih.gov/pubmed/) for articles related with the material characteristics of cerebrovascular stent materials and complications after implantation, published between January 1999 and December 2009, using the key words of “intravascular stent, cerebrovascular disease, complications” in Chinese. Totally 21 articles were screened into the evaluation.
RESULTS: The cerebrovascular stent complications include carotid sinus response, high-perfusion syndrome, cerebral vasospasm, thrombosis, restenosis and so on. In a variety of cerebrovascular stents, metal stents are prone to promote thrombosis; polymer stents have better compatibility with vessel wall than metal stents, thus preventing late neointimal proliferation; coated stent can coat metal stent surface with a special coating technology, inhibiting platelet aggregation; drug stents can achieve high concentrations of drugs sustained release after implantation, the drugs can reach effective therapeutic concentrations in target site and effectively prevent restenosis after implantation. The incidence of complications after stenting is difficult to completely eradicate, but they should be avoided, it is suggested to select positive solutions for stent cases, improve the operator’s proficiency, correct bad operation habits, better the patient’s understanding of the complications, strictly perform perioperative management, timely and correctly give treatment of the complications to avoid serious consequences.
CONCLUSION: The treatment of cerebral vascular stent implantation can be considered as one of the main treatments for cerebrovascular disease, during treatment, adequate preparation, appropriate stent, and strictly follow of the indications are required to avoid complications according to different clinical symptoms.

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