目的:观察缺血性脑血管病药物治疗与主动脉弓Myla分型的介入治疗的效果与不良事件发生率。方法:选取巴彦淖尔市医院2018—2021年的120例缺血性脑血管病患者作为研究对象,根据治疗方法不同,分为药物组与手术组;药物组进行传统的药物治疗;手术组在患者主动脉弓分型基础上,根据不同主动脉弓采用相应的术式,观察两组患者的血管狭窄程度、手术时间、不良事件发生率等。结果:(1)药物组1支血管狭窄占55.0%,手术组为53.3%,两组中都以1支血管狭窄为主,血管狭窄数量组间相比,差异无统计学意义;(2)手术时间2支以上血管病变的患者所需要时间长于仅1支血管病变者;(3)各型主动脉分型中,以常规技术(术式1)为主要术式(79.67%),采用最少的是交换技术(术式3)(5.09%);(4)长期随访结果显示,3支及以上血管狭窄不良事件发生率较高;组间相比,3个月时,药物组不良事件发生率为26.7%,高于手术组的8.3%;12个月时,药物组为58.3%,高于手术组的23.3%。结论:(1)血管狭窄数量越多,手术时间越长;(2)主动脉分型与患者采用的术式有密切关系,无论哪种分型,患者以常规技术(术式1)为主;(3)无论哪种治疗方式,缺血性脑血管病主要的不良事件是短暂性脑缺血发作(transientischemicattack,TIA)。

Objective: To observe the effect and the incidence of adverse events of drug treatment and interventional treatment of aortic arch Myla classification for patients with ischemic cerebrovascular disease. Methods: A total of 120 patients with ischemic cerebrovascular disease in Bayannur City Hospital from 2018 to 2021 were selected as the research objects. According to different treatment methods, they were divided into drug group and surgical group. The drug group was treated with traditional drugs; on the basis of the classification of aortic arch, the patients in the surgical group were treated with corresponding surgical methods according to different aortic arches. The degree of vascular stenosis, operation time and incidence of adverse events were observed in the two groups. Results: (1)One vessel stenosis accounted for 55.0% in the drug group and 53.3% in the surgical group. Patients in both groups were mainly with one vessel stenosis, and there was no significant difference in the number of vascular stenosis between the two groups; (2)The surgical time of patients with more than two vascular lesions was longer than that of patients with only one vascular lesion; (3)In each type of aortic classification, the conventional technique (surgical 1) was the main surgical (79.67%), and the exchange technique (surgical 3) was the least used (5.09%). (4)Long-term follow-up results showed that the incidence of adverse events in 3 or more vascular stenosis was higher; the results of inter-group comparison showed that the incidence of adverse events in the drug group was 26.7% at 3 months after surgical, which was higher than 8.3% in the surgical group, while at 12 months after surgical, the incidence of adverse events in the drug group was 58.3% in the drug group, which was higher than 23.3% in the surgical group. Conclusion: (1) The more the number of vascular stenosis, the longer the surgical time; (2) Aortic classification is closely related to the type of operation adopted by the patients. No matter which type, the patients are mainly treated with conventional technique (surgical 1). (3)No matter what kind of treatment, the main adverse event of ischemic cerebrovascular disease is transient ischemic attack (TIA).