颈动脉内膜切除术后早期安全性分析  

Clinical analysis on the early complications after carotid endarterectomy

作　　者：布茂振 尹国阳[2] 张利勇[2] 张士刚[2] 王继跃[2] 

机构地区：[1]山东省聊城市阳谷县人民医院神经内科,252300 [2]山东省聊城市人民医院神经外科,252000

出　　处：《中国现代神经疾病杂志》2015年第4期296-301,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的回顾分析颈动脉内膜切除术后早期并发症发生原因及其影响因素,以评价颈动脉内膜切除术后早期安全性。方法 396例颈动脉狭窄患者共完成407例次颈动脉内膜切除术,于术后30 d评价手术疗效,单因素和多因素Logistic回归分析评价术后30 d内不良事件相关影响因素。结果 407例次颈动脉内膜切除术成功率为100%,术后30 d内主要并发症发生率4.42%(18/407)、次要并发症24.08%(98/407)。Logistic回归分析显示,仅吸烟(P=0.039)和入院时改良Rankin量表(mRS)评分≥3分(P=0.001)为颈动脉内膜切除术后早期(30 d内)不良事件的独立危险因素。结论颈动脉内膜切除术后并发症发生率较低、安全性较高,积累手术经验、提高手术技巧有助于减少术后并发症。吸烟和入院时mRS评分≥3分患者围手术期并发症发生率显著高于其他患者。Objective To analyze the influencing factors of early complications after carotid endarterectomy（CEA）, in order to evaluate the early safety after CEA. Methods A total of 396 patients with carotid stenosis underwent 407 CEAs, and the complications within 30 d after CEA were analyzed.Univariate and backward multivariate Logistic regression analysis were used to evaluate the related risk factors for major adverse events within 30 d after CEA. Results The success rate of 407 CEAs was100%. Major complications within 30 d after CEA occurred in 18 cases（4.42%）, including 5 cases（1.23%）of death, 8 cases（1.97%） of ischemic stroke and 5 cases（1.23%） of cerebral hemorrhage. Secondary complications occurred in 98 cases（24.08%）. Logistic regression analysis revealed smoking（P = 0.039） and modified Rankin Scale（mRS） score on admission≥3（P =0.001） were the independent risk factors for early adverse events（within 30 d） after CEA. Conclusions CEA is a safe surgical method with a low incidence rate of postoperative complications, which could be decreased by improving surgical skills and gathering surgical experiences. Smoking and mRS score on admission ≥ 3 can increase the risk of CEA.

关 键 词：颈动脉内膜切除术 手术后并发症 危险因素 回归分析 

分 类 号：R653[医药卫生—外科学]