冠心病合并颈动脉狭窄的外科治疗  

The surgical treatment of Coronary Heart Disease(CHD) associated with carotid stenosis

作　　者：曹卫东[1] 高晓丽[2] 赵亮[1] 姜华[1] 

机构地区：[1]新疆医科大学第五附属医院心胸外科,乌鲁木齐830011 [2]新疆医科大学第五附属医院超声诊断科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2011年第10期1128-1130,共3页Journal of Xinjiang Medical University

基　　金：新疆医科大学创新基金资助项目(XJC201079)

摘　　要：目的探讨冠心病并发颈动脉狭窄同期手术治疗的治疗经验,并对手术指征和手术步骤进行分析。方法选择冠心病并发颈动脉狭窄患者15例,其中10例行颈内动脉内膜剥脱术(CEA),后在心脏停跳下行冠状动脉旁路移植术(on-pump CABG);5例行CABG,后在心脏停跳下行CEA,其中3例同期行二尖瓣成形术,1例行二尖瓣膜置换术。结果 15例患者手术全部成功,术后25d内无死亡,术后6个月～1年复查未发现持续和短暂神经系统症状,无心绞痛和心肌梗死发生。结论冠心病并发颈动脉狭窄,同期行CABG和CEA是一种较好的手术方法。Objective To explore the experiences the surgical treatment of coronary heart disease（CHD） associated with carotid stenosis and analyze the the operational indications and operation procedures.Methods Fifteen patients underwent simultaneous carotid endarterectomy（CEA） and coronary arteryby pass grafting（CABG）.10 patients underwent CEA at first,then on-pump CABG.5 patients underwent on pump CABG at first,then underwent CEA,three of them concomitant mitral valve plasty.Only 1 case underwent mitral valve replacement.Results no patients died in 25 days after operation.The patients were followed up by 6-12 months and no gross neurologic complications or myocardial infarction took place.Conclusion Combined CABG/CEA may in fact reduce the risk,which is a good method for simultaneous repair of coronary and carotid lesions in patients with concomitant disease.

关 键 词：冠状动脉旁路移植术 颈动脉内膜剥脱术 冠状动脉疾病 颈动脉狭窄 

分 类 号：R655[医药卫生—外科学] R543.3[医药卫生—临床医学]