颈动脉内膜剥脱术后不同抗凝抗栓治疗对早期并发症的影响  

The effects of different anticoagulative and antithrombotic managements on early postoperative comoplications for patients with carotid endarterectomy

作　　者：李强[1,2] 孙建萍[1,2] 仲维佳[1,2] 张京岚[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所综合外科监护,北京100029

出　　处：《心肺血管病杂志》2013年第3期291-294,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析颈动脉内膜剥脱术(CEA)后抗凝等内科治疗对围术期并发症发生情况的影响。方法:回顾2010年5月至2012年7月,于我院行颈动脉内膜剥脱术患者144例临床资料,根据术后不同处理分为肝素组(H组,n=52)和低分子右旋糖酐复合阿司匹林组(DA组,n=90),观察两组患者一般状况,比较不同术后治疗患者围术期并发症情况。结果:肝素组及低分子右旋糖酐组患者并发症的发生例数和发病率分别为:伤口血肿4例(7.7%)和4例(4.4%);高灌注综合征5例(9.6%)和3例(3.3%);围术期脑卒中1例(1.9%)和2例(2.2%);术后高血压36例(69.2%)和68例(75.6%);术后低血压4例(7.7%)和3例(3.3%);围术期急性冠状动脉综合征1例(1.9%)和3例(3.3%),两组间比较差异无统计学意义(P>0.05)。结论:在严格控制血压条件下,颈动脉内膜剥脱术后应用肝素和低分子右旋糖酐复合阿司匹林两种治疗,对患者术后恢复安全性的影响无明显区别,应密切观察患者颈部伤口情况及新发神经定位体征情况。Objective：To analysis the relationship between early complications and different postoperative medical treatments on the patients after carotid endarterectomy（CEA）.Methods： Review the postoperative data from the cases who undertook carotid endarterectomy in Beijing Anzhen Hospital from May,2010 to July,2012.There were totally 142 cases,According to their postoperative managements,they were separated into 2 groups.Group H（n=52）,patients took heparin for postoperative anticoagulation,Group DA（n=90）,patients were treated with low molecular dextran combined with aspirin for postoperative anticoagulation.With statistical analysis,the general state of the two groups and the incidence of the early postoperative complications related to different medical treatments were compared.Results： The complications in Group H and Group DA were as follows： postoperative incisional hematoma（4 cases,7.7% and 4 cases,4.4%）,hyperperfusion syndrome（5 cases,9.6% and 3 cases,3.3%）,perioperative stroke（1 case,1.9% and 2 cases,2.2%）,postoperative hypertension（36 cases,69.2% and 68 cases,75.6%）,postoperative hypotension（4 cases,7.7% and 3 cases,3.3%）,Perioperative acute coronary syndromes（1 case,1.9% and 3 cases,3.3%）.There is no statistical difference between two groups.Conclusion： The two different medical treatments after carotid endarterectomy are safe and effective.But during the preoperative period,it is important to tightly control blood pressure,intensively observe the neck incision area and new nervous localization physical signs.

关 键 词：颈动脉内膜剥脱术 术后内科治疗 术后并发症 

分 类 号：R54[医药卫生—心血管疾病]