颈动脉狭窄的显微外科治疗  

Microsurgical Treatment of Carotid Stenosis

作　　者：时飞[1] 姜虹宇 时忠华[1] 陈罡[3] 黄亚波[3] 

机构地区：[1]解放军第101医院神经外科,江苏无锡215006 [2]无锡第三人民医院麻醉科,江苏无锡214000 [3]苏州大学附属第一医院神经外科,江苏苏州215006

出　　处：《现代生物医学进展》2015年第3期484-486,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金青年科学基金项目(81100872)

摘　　要：目的:评价颈动脉内膜剥脱术治疗颅外颈动脉狭窄的疗效,以及经颅多普勒超声(TCD)、微血管多普勒超声(MVD)应用的价值。方法:回顾性分析2012年5月至2013年5月采用颈动脉内膜剥脱术治疗的19例颅外颈动脉狭窄的资料。均伴有不同程度的脑缺血症状。颈动脉狭窄程度2例中度狭窄,17例重度狭窄。同时行颈动脉内膜剥脱术均在显微镜下操作。1例采用补片成形。18例术中采用TCD及MVD监测下完成,1例未采用超声监测。结果:手术成功率为100%,无死亡率。术前脑缺血症状术后患者均有不同程度的恢复。均未发现过度灌注的并发症。结论:颈动脉内膜剥脱术治疗颅外颈动脉狭窄是一种安全、有效的措施;MVD及TCD监测对于显微手术有着重要意义。Objective： To evaluate the effect of carotid endarterectomy on extracranial carotid artery stenosis and the role of transcranial Doppler （TCD） and Microvascular Doppler （MVD） in carotid endarterectomy. Methods： From May 2012 to May 2013, 19 patients were selected in our hospital. All patients had symptoms of cerebral ischemia. 2 patients had middle carotid artery stenosis and the others had severe carotid artery stenosis. All patients were under microsurgery. Only 1 patient had angioplasty with arterial patch. TCD and MVD monitoring was used in the surgery of 18 patients while 1 patient was not. Results： Surgery was successful in all patients. Cerebral ischemic symptoms improved to a certain degree in all the 19 preoperative symptomatic patients. No hyperperfusion was found in these patients. Conclusions： Carotid endarterectomy is a safe and effective procedure for treating extraeranial carotid artery stenosis. MVD and TCD monitoring is valuable in microsurgery.

关 键 词：颈内动脉狭窄 颈动脉内膜剥脱术 微血管多普勒超声 显微外科手术 

分 类 号：R743[医药卫生—神经病学与精神病学]