【摘要】 目的:探讨症状性脑动脉狭窄支架置入术后并发高灌注综合征的原因,高危因素及预防措施。方法:对2例支架置入术后出现脑内血肿及蛛网膜下腔出血患者进行原因分析并复习文献。结果:1例右侧颈内动脉起始段及右侧大脑中动脉M1段狭窄患者,各置入1个支架,术后4h后出现颅内出血,经积极救治仍死亡;另1例患者于右侧颈内动脉、右侧椎动脉颈段及起始部置入3个支架,术后6h出现蛛网膜下腔出血,对症处理后痊愈出院。结论:高龄患者,重度狭窄且侧支循环欠佳,血流量的储备能力或血管的反应性低下,对侧颈动脉闭塞,具有同侧慢性低灌注,术前及术后高血压等是高灌注综合征的危险因素。术后TCD监测和严格的血压控制,是及早发现和预防术后高灌注综合征发生的重要措施。更多还原

【Abstract】 Objective:To discuss the cause,risk factors and prophylactic measures for syndrome of hyperperfusion after stent implantation for stenosis of seribral artery.Method:Clinical data of 2 cases of arterial stenosis with the complication of Hyperperfusion syndrome after stent implantation and the pertinent literatures were reviewed.Result:A patient with stenosis in right initial segment of internal carotid artery and M1 segment of right Middle cerebral artery that was implanted with a stent each suffered from intracranial hemorrhage 4 hours after operation.The patient eventually died despite of active rescue.In another patient with stenosis in the initial segment of internal carotid artery,initial and cervical segment of veterbral artery that was treated with a stent each,subarachnoid hemorrhage occurred 6 hours after stent implantation.Conclusion:Old age,severe stenosis,decreased reserve capacity of blood flow or reactivity of blood vessels,occlusion of contralateral carotid artery concurrent with chronic isolateral low perfusion,preoperative and postoperative hypertension are risk factors responsible for postoperative hyperperfusion syndrome.Strict control of blood pressure and monitoring with transcranial doppler are important inpreventing the occurrence of postoperative hyperperfusion syndrome.更多还原