颈动脉狭窄的外科手术治疗  

Carotid endarterectomy for carotid artery stenosis

作　　者：王子军[1] 武国栋[1] 赵金超[1] 邵磊[1] 张方[1] 陈学明[2] 

机构地区：[1]北京市房山区第一医院胸心血管外科,北京102400 [2]首都医科大学附属友谊医院血管外科,北京100050

出　　处：《中国普通外科杂志》2011年第12期1304-1306,共3页China Journal of General Surgery

摘　　要：目的探讨颈动脉内膜切除术(CEA)治疗颈动脉狭窄的疗效。方法对2001年1月—2011年5月90例颈动脉狭窄患者行颈动脉内膜切除术93次,其中男78例,女15例;年龄50～78(平均65.6岁)。术前有短暂性脑缺血发作62例(TIA),31例术前患过脑梗死。所有患者术前均行脑血管造影和\或CTA明确颈动脉狭窄,狭窄程度均>80%。对侧颈动脉狭窄或闭塞者22例。结果 90例术后临床症状改善,包括TIA消失,记忆力明显好转,语言障碍恢复等。术后80例获得随访1～36个月。15例发现有手术部位再狭窄,狭窄率小于25%,其中1例脑卒中,1例TIA保守治疗好转。其余13例无临床症状。结论颈动脉内膜切除术是治疗颈动脉狭窄的安全、有效的方法。Objective To investigate the efficacy of carotid endarterectomy（CEA） in treatment of carotid artery stenosis.Methods From January 2001 to May 2011,CEA was performed 93 times in 90 patients with carotid artery stenosis.Of whom,78 cases were male and 15 cases were female,and the ages ranged from 50 to 78 years（average of 65.6 years）.Of the patients,62 cases experienced transient ischemic attack（TIA） and 31 cases suffered cerebral infarction before surgery.All the patients had confirmed diagnosis of carotid artery stenosis greater than 80% by cerebral angiography and/or CT angiography（CTA）.Twenty-two patients had contralateral carotid stenosis or occlusion.Results The clinical symptoms,such as the disappearance of TIA and the recovery of memory or language problems,improved after surgery in all the 90 patients.Eighty patients were followed up for one month to 36 months after surgery.Restenosis of the surgical site occurred in 15 cases（stenosis less than 25%）,one of whom developed a stroke and another one had TIA that was improved by conservative treatment.The remaining 13 cases had no clinical symptoms.Conclusions CEA is a safe and effective procedure for treatment of carotid artery stenosis.

关 键 词：颈动脉狭窄/外科学 颈动脉内膜切除术/方法 预后 

分 类 号：R654.3[医药卫生—外科学]