标准式与翻转式颈动脉内膜切除术的对比分析  

Contrast Analysis of Standard and Eversion Carotid Endarterectomy

作　　者：王继跃 郝继恒 

机构地区：[1]山东聊城市脑科医院神经外科,聊城252000

出　　处：《中国卒中杂志》2013年第3期177-182,共6页Chinese Journal of Stroke

摘　　要：目的探讨标准式颈动脉内膜切除术(standard carotid endarterectomy,sCEA)和翻转式颈动脉内膜切除术(eversion carotid endarterectomy,eCEA)治疗颈动脉狭窄的临床应用。方法回顾性分析2008年4月～2011年10月我科住院的颈动脉狭窄惠者265例(其中11例患者分期行双侧手术,每例按2例单独病例进行计算,共计276例)。根据狭窄的部位和程度采取标准式与翻转式两种不同手术方式,sCEA组80例,eCEA组1 96例。回顾性分析两种术式患者术中阻断时间、术中神经损伤发生率、术后症状缓解率、术中转流管的应用及术后血管再狭窄率。结果两组患者术中阻断时间[sCEA组(25.3±11.2)min vs eCEA组(23.1±9.8)min,P=0.106]、神经损伤发生率[sCEA组(3.75%) vs eCEA组(6.12%),P=0.62]、术后症状缓解率[sCEA组(95.00%)vs eCEA组(96.93%),P=0.669]差异均无显著性。术中应用转流管12例。术后再狭窄率sCEA组2例(2.50%),eCEA组无再狭窄患者,差异具有显著性(P=0.026)。随访3～35个月,两组惠者均未再有新发脑梗死。结论标准式及翻转式颈动脉内膜切除术均可有效地治疗颈动脉狭窄。Objective To investigate the application of standard and eversion carotid endarterectomy for carotid artery stenosis in clinical practice. Methods The clinical data of 265 patients with carotid stenosis（11 of them underwent bilateral operation at two different stages. Each patient was calculated as 2; therefore, there was a total of 276 patients） treated with carotid endarterectomy from April 2008 to October 2011 were analyzed retrospectively. Our study had 80 cases undergoing standard carotid endarterectomy（sCE） and 196 cases treated with eversion carotid endarterectomy（eCEA）. Clamp time, nerve injury rate, remission rate, restenosis rate and application of bypass pipe were analyzed retrospectively. Results There were no significant differences in the clamp time（sCEA[25.3：i：l 1.2]min vs eCEA [23.1~9.8]min, P=0.106）, nerve injury rate（sCEA[3.75%] vs eCEA[6.12%], P=0.62）, remission rate（sCEA[95.00%] vs eCEA[96.93%], P=0.669） between both groups. During the operation, there were 12 patients who used bypass pines. There was significant difference in the restenosis rate between both groups. Two cases treated with sCEA developed restenosis（2.50%）, and none treated with eCEA developed restenosis（P=0.026）. No ischemic stroke occurred in both groups after a follow-up period ranging from 3 to 35 months. Conclusion Both sCEA and eCEA can effectively treat carotid artery stenosis.

关 键 词：颈动脉内膜切除术 颈动脉狭窄 标准式 翻转式 

分 类 号：R651.1[医药卫生—外科学]