颈动脉内膜剥脱术治疗颈动脉粥样硬化狭窄的临床研究  

Clinical study of carotid endarterectomy in treating carotid atherosclerosis stenosis

作　　者：陈学东[1] 王中华[1] 田磊[1] 杨晓冬[1] 王世华[1] 

机构地区：[1]海军总医院普外科,北京100048

出　　处：《转化医学杂志》2013年第4期216-218,共3页Translational Medicine Journal

摘　　要：目的探讨颈动脉内膜剥脱术(carotid endarterectomy,CEA)的适应证及围手术期处理。方法回顾性总结2001年2月—2011年2月在我科治疗的98例因颈动脉硬化狭窄(狭窄>50%)而行CEA治疗的患者资料;其中,有症状77例(78.6%),无症状21例(21.4%)。结果术后除2例(2.0%)死亡、3例(3.0%)发生一过性偏瘫和7例(7.1%)出现脑高灌注综合征外,其他患者疗效良好,未出现短暂脑缺血(transient ischemic attack,TIA)表现。术后随访1～10年,平均5.6年;随访76例,13例(17.1%)再狭窄>70%,9例(11.8%)再发TIA症状,4例(5.3%)出现脑梗死。结论对于临床检查发现一侧或双侧颈动脉狭窄>50%,特别是有TIA发作史的患者,可以考虑行CEA;双侧颈动脉狭窄者应分期手术治疗;做好围手术期处理,有助于减少手术并发症发生。ObjectiveTo study the indications of carotid endarterectomy（CEA） and perioperative managements. MethodsThe clinical data of 98 patients with carotid stenosis（stenosis〉50%） who underwent CEA were reviewed in our department from Feb. 2001 to Feb. 2011 retrospectively. Among them, there were 77 patients（786%） with transient ischemic attack （TIA） and 21（214%）with asymptom. ResultsIn addition to the death of two patients （2%）, 3 cases （30%） with transient hemiplegia and 7 cases （71%） with cerebral hyperperfusion syndrome during postoperation, other patients all got a curative effect and didnt appear TIA symptoms later. Seventy six patients were followed up for 1—10 years, the average time was 56 years, 13 cases （171%） with restenosis more than 70%, 9 patients （118%） with recurrent TIA symptoms, and 4 cases （53%） with cerebral infarction. ConclusionClinical examination found that unilateral or bilateral carotid stenosis for more than 50%, especially in patients with a history of TIA episodes, can be considered for CEA treatmentStaging surgery should be adopted in treating bilateral carotid stenosis,and paying attention to perioperative management can help reduce surgical complications.

关 键 词：颈动脉内膜剥脱术 颈动脉狭窄 脑缺血 

分 类 号：R653[医药卫生—外科学] R543.4[医药卫生—临床医学]