颈动脉内膜剥脱术及颈动脉支架置入术治疗颅外颈动脉硬化狭窄术后早期并发症比较  

COMPARISON OF EARLY COMPLICATIONS IN TREATMENT OF CAROTID ARTERY STENOSIS WITH CAROTID ENDARTERECTOMY AND CAROTID STENTING

作　　者：卫志庆[1,2] 杨其鹏[2] 黄佃[1] 乔威[1] 刘长建[1] 

机构地区：[1]南京大学医学院附属鼓楼医院血管外科,南京210008 [2]南京医科大学第二附属医院血管外科

出　　处：《中国修复重建外科杂志》2011年第3期337-340,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较颈动脉内膜剥脱术(carotid endarterectomy,CEA)及颈动脉支架置入术(carotid stenting,CAS)治疗颅外颈动脉硬化狭窄后早期并发症发生情况,为临床治疗方法的选择提供理论依据。方法 2005年1月-2007年12月,分别采用CEA(CEA组,36例)和CAS(CAS组,27例)治疗63例颅外颈动脉狭窄患者。男42例,女21例;年龄52～79岁,平均67.5岁。左侧28例,右侧35例。颈动脉狭窄度为60%～95%,平均79%。主要临床症状为中风和短暂性脑缺血发作。头颅CT检查:24例有陈旧性脑梗死(cerebral infarction,CI),22例见多发性腔隙性CI,余17例未见明显异常。分析两种术式治疗后7 d内脑部、心血管及局部并发症发生情况。结果术后7 d内CEA组3例(8.3%)出现脑部并发症,2例(5.6%)出现心血管并发症,5例(13.9%)出现局部并发症;CAS组8例(29.6%)出现脑部并发症,1例(3.7%)出现心血管并发症,3例(11.1%)出现局部并发症;CAS组患者脑部并发症发生率明显高于CEA组,差异有统计学意义(χ2=4.855,P=0.028);但两组心血管、局部并发症发生率以及总并发症发生率比较,差异均无统计学意义(P>0.05)。结论对于颅外颈动脉硬化狭窄患者,CEA是首选治疗方式。Objective To compare the early compl ications of carotid stenting （CAS） and carotid endarterectomy （CEA） in treatment of carotid artery stenosis. Methods Between January 2005 and December 2007, 63 patients with carotid artery stenosis were treated with CEA in 36 cases （CEA group） and with CAS in 27 cases （CAS group）. There were 42 males and 21 females with an average age of 67.5 years （range, 52-79 years）. The locations were the left side in 28 cases and the right side in 35 cases. The carotid stenosis was 60%-95% （mean, 79%）. The major cl inical symptoms were stroke and transient ischemic attack. The cranial CT showed old cerebral infarction in 24 cases, lacunar infarction in 22 cases, and no obvious abnormal change in 17 cases. The encephalon, heart, and local compl ications were compared between 2 groups within 7 days after operation. Results In CEA group, encephalon compl ications occurred in 3 cases （8.3%）, heart compl ications in 2 cases （5.6%）, and local compl ications in 5 cases （13.9%）; while in CAS group, encephalon compl ications occurred in 8 cases （29.6%）, heart compl ications in 1 case （3.7%）, and local compl ications in 3 cases （11.1%）. The encephalon compl ication ratio of CAS group was significantly higher than that of CEA group （χ2=4.855, P=0.028）; and there was no significant difference in other compl ications ratios between 2 groups （P 〉 0.05）. Conclusion CEA is the first choice to treat carotid artery stenosis.

关 键 词：颈动脉狭窄 颈动脉内膜剥脱术 颈动脉支架置入术 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]