颈动脉内膜切除术相关并发症的预防及处理  

Prevention and treatment of complications associated with carotid endarterectomy

作　　者：王继跃 刘卫东 

机构地区：[1]聊城市脑科医院神经外科,252000

出　　处：《中国微侵袭神经外科杂志》2014年第5期196-198,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家"十二五"科技支撑计划项目(编号:2011BAI08B04)

摘　　要：目的探讨颈动脉内膜切除术(carotid endarterectomy,CEA)并发症的预防及处理。方法回顾性分析311例行CEA的病例资料。采用外翻式CEA 215例,标准CEA 96例。结果术后出现脑卒中5例(1.6%),其中1例(0.3%)出现大面积脑梗死而死亡,4例经治疗后好转。高灌注综合征35例(11.2%),脑出血1例(0.3%),周围神经损伤16例(5.1%),手术区血肿5例(1.6%),手术切口感染3例(0.9%),再狭窄2例(0.6%)。结论 CEA术前严格把握手术适应证,术中仔细操作,术后早期发现积极治疗可有效减少并发症的发生。Objective To analyze the prevention and treatment of complications after carotid enarterectomy （CEA）. Methods Clinical data of 311 patients undergoing CEA were analyzed retrospectively. The eversion CEA was performed in 215 patients and standard CEA in 96. Results Five （1.6%） patients developed cerebral apoplexy after operation, of them 1 （0.3%） patient suffered serious cerebral infarction and death, 4 patients recovered well after treatment. There was hyperperfusion syndrome in 35 （11.2%） patients, cerebral hemorrhage in 1 （0.3%）, peripheral nerve injuries in 16 （5.1%）, surgical incision hematoma in 5 （1.6%）, surgical incision infection in 3 （0.9%）, and carotid restenosis in 2 （0.6%）. Conclusions Strict selection of patient preoperation, careful operation intraoperation, active therapy postoperation can effectively reduce the complications of CEA.

关 键 词：颈动脉内膜切除术 并发症 预防 处理 

分 类 号：R743.3[医药卫生—神经病学与精神病学]