动脉内膜切除治疗颈动脉狭窄  

Endarterectomy for carotid stenosis

作　　者：周定标[1] 程东源[1] 许百男[1] 余新光[1] 雪梅[1] 

机构地区：[1]中国人民解放军总医院种经外科,北京100853

出　　处：《中华医学杂志》1999年第11期816-818,共3页National Medical Journal of China

基　　金："九五"国家重点科技攻关资助!96-906-02-25;"九五"军队医药卫生科研基金!96Z058

摘　　要：目的探讨颈动脉内膜切除的手术指征、麻醉和手术方法。方法20例病人22侧颈动脉狭窄，其中21侧在全麻下手术，1侧采用局麻。20侧术中颈动脉阻断时间27～52分钟（平均35．5分钟），2侧术中采用分流。15侧手术在脑电图监测下进行。结果17例病人18侧术后恢复顺利；另3例4侧手术，其中3侧术后分别出现暂时性肌力减退和下部面瘫。19例病人平均随访3年2个月，9例暂时性脑缺血病人中，8例停止发作，1例发作减少；9例脑梗死病人，6例症状改善；1例无症状者术后仍正常。结论内膜切除是颈动脉狭窄安全有效的治疗方法。Objective To discuss the indications, anesthesia and surgical techniques of carotid endarterectomy (CEA). Methods Twenty-two sides of carotid stenosis were revealed in 20 patients. CEA was performed under general anesthesia in 21 sides and local anesthesia in one. The time of carotid occlusion ranged from 27 to 52 minutes (averag 35 .5 min) in 20 operations, and intraoperative shunt was used in the other two.Fifteen operations were monitored with EEG. Results The postoperative course was uneventful in 17 patients after 18 operations, while transient muscle strength decrease on contralateral side and ipsilateral lower facial paresis occurred after three operations in the other three patients. Nineteen patients were followed-up for 38 months on the average. Among nine patients with TLA, ischemic attacks ceased in eight and decreased in one. Improvement was achieved in six patients with cerebral infarction. One patient without symptoms of carotid ischemia was still normal after operation. Conclusion Carotid endarterectomy is a safe and effective way for treating carotid stenosis.

关 键 词：治疗 颈动脉狭窄 动脉内膜切除术 脑缺血 

分 类 号：R743.310.5[医药卫生—神经病学与精神病学] R543.405[医药卫生—临床医学]