颈动脉内膜切除术相关并发症及处理  

Postoperative complications of carotid endarterectomy and its management

作　　者：栗力[1] 刘洪[1] 于国涛[1] 崔若昱[1] 周宁[1] 潘仲杰[1] 李阳春[1] 

机构地区：[1]天津市人民医院血管科,300121

出　　处：《中华普通外科杂志》2005年第9期555-557,共3页Chinese Journal of General Surgery

摘　　要：目的分析颈动脉内膜切除术(carotid endarterectomy,CEA)后并发症的原因并探讨其处理原则。方法回顾性总结1992年2月至2002年3月280例颈动脉内膜切除术(其中治疗陈旧性脑中风242例,预防性颈动脉内膜切除术38例)的临床资料。结果术后合并高血压59例(21·1%)、低血压30例(10·7%)、脑灌注损害16例(5·7%)、皮下血肿5例(1·8%)、脑卒中5例(1·8%)、颈动脉血栓4例(1·4%)、颅神经损害1例(0·4%)。术后随访:5年内血管再狭窄73例(26·1%)。结论根据残端指数选择性应用临时性转流,术中严格控制血压可减少术后并发症的发生。Objective To analyze the causes and management of postoperative complications of carotid endarterectomy （CEA）. Methods Between Feb 1992 and Mar 2002, a total of 280 cases underwent carotid endarterectomy, including elective surgery in 242 cases and prophylactive procedure in 38 cases, Results Postoperative hypertension developed in 59 cases （21. 1% ）, hypotension in 30 cases （ 10. 7% ） ,cranium reperfusion injury in 16 cases （5.7%）, subcutaneous haematoma in 5 cases （ 1.8% ）, stroke in 5 cases （ 1.8% ）, acute internal carotid thrombosis in 4 cases （ 1. 4% ） ,and cranium neurological deficits in 1 case （0.4%）. Recurrent stenosis developed in 73 cases （ 26. 1% ） during a follow-up period of 5 years. Conclusion Use of temporal shunt selectively according to the internal carotid stump index, controlling blood pressure strictly help to reduce the occurrence of postoperative complications.

关 键 词：颈动脉内膜切除术 并发症 脑卒中 血压控制 血管狭窄 

分 类 号：R651.12[医药卫生—外科学]