微创医学

目的探讨血管重建术对颈动脉严重狭窄患者认知功能的变化情况，并进一步研究作用机制。方法将颈动脉严重狭窄的107例患者，根据治疗方法的不同分为治疗组（血管重建）54例和对照组（药物治疗）53例。采用蒙特利尔认知评估量表（MoCA）和搭火柴测验（Stick Test）对患者手术不同时期的认知能力进行综合比较。结果手术前治疗组和对照组的MoCA总分、Stick Test评分等指标比较，差异无统计学意义（P＞0.05）；对照组治疗前后MoCA总分、Stick Test评分等指标差异无统计学意义（P＞0.05）；治疗组术后1周MoCA总分、延迟回忆、注意力、Stick Test评分较治疗前降低，差异具有统计学意义（P＜0.05），术后3个月和6个月MoCA总分、延迟回忆、注意力、Stick Test评分等方面评分上升均较治疗前明显改善，差异具有统计学意义（P＜0.05）。结论颈动脉狭窄会造成认知功能降低，血管重建术可改善患者的认知功能，值得在临床上推广应用。

ObjectiveTo evaluate the cognitive function changes of patients with severe carotid artery stenosis treated by vascular reconstruction, and to research its mechanism. Methods107 cases of the severe carotid artery stenosis were divided into treatment group (n=54, treated b vascular reconstruction)and control group(n=53, only receiving drug treatment). Montreal Cognitive Assessment (MoCA) and Stick Test were used to evaluate cognitive function changes. ResultsThe scores of MoCA and Stick Test between treatment group and control group before treatment were comparable (P＞0.05). In control group, there were no significant differences in the scores of MoCA and Stick before and post treatment (P＞0.05). In treatment group, the score of MoCA, delayed recall, attention, Stick Test in one week of postoperation was lower than those before the treatment, the difference was statically significant (P＜0.05), so were those of 3 months and 6 months of postoperation (P＜0.05). ConclusionVascular reconstruction can improve the cognitive function impaired by severe carotid artery stenosis, worthy of clinical promotion