冠状动脉搭桥术前超声检测颈动脉狭窄的临床意义  

Clinical Significance of Carotid Stenosis Assessed by Vascular Ultrasound Before Coronary Artery Bypass Graft

作　　者：刘芳[1] 杨浣宜[2] 祁芸云[1] 欧阳福珍[1] 

机构地区：[1]北京大学第一医院老年科,北京市100034 [2]中国医学科学院北京阜外心血管病医院

出　　处：《中国超声医学杂志》2008年第2期143-146,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价血管超声技术应用于冠状动脉搭桥术(CABG)前的临床价值及意义。方法随机抽取拟行CABG的住院患者共104例,年龄(68.9±6.09)岁,于CABG前1周之内进行颈动脉超声检查,判断颈动脉狭窄程度,对颈动脉超声提示重度狭窄和/或闭塞的患者进行颈动脉造影检查并依据检查结果进行干预治疗。结果颈动脉重度狭窄和/或闭塞患者超声和造影检查结果具有很好的相关性(相关系数r=0.92,P<0.001)。对颈动脉超声和造影均显示重度狭窄和/或闭塞的10例患者在CABG前进行了颈动脉内膜剥脱术(CEA)或颈动脉支架置入术(CAS),这些患者在CABG围术期无1例脑血管并发症发生。结论应用血管超声技术可准确检测颈动脉狭窄程度,其结果与颈动脉造影具有很好的相关性,依据颈动脉超声及造影结果,对严重狭窄和/或闭塞的颈动脉进行介入治疗或手术治疗可明显降低CABG围术期脑卒中的发生率。Objective To evaluate the clinical significance of the carotid stenosis assessed by vascular ultrasound before undergoing coronary artery bypass graft. Methods A total of 104 patients （aged 68, 9 ±6.09 years） with coronary heart disease were scanned carotid arteries before CABG. Those patients whose carotid stenosis were severe and/or total occlusion according to carotid ultrasound were examined carotid angiography. Results There was a strong correlation between carotid ultrasound and angiography in the patients with severe carotid stenosis and/or total occlusion （r= 0. 92, P〈0. 001） . There was none of cerebral complication in the 10 patients with severe carotid stenosis and/or total occlusion in the CABG perioperation period after undergoing carotid endarterectomy （CEA） or carotid artery stenting （CAS） . Conclusions The results from carotid ultrasound were accurate and correlated strongly with that from carotid angiography, Undergoing CEA or CAS in those patients with severe carotid stenosis and/or total occlusion was helpful for reducing the morbidity of cerebral complication accompanying with CABG.

关 键 词：血管超声 冠状动脉搭桥术 颈动脉狭窄 

分 类 号：R654.2[医药卫生—外科学] R543.4[医药卫生—临床医学]