颈动脉内膜剥脱术中不同监测的应用特点及进展  

Characteristics and advances of monitoring techniques in carotid endarterectomy

作　　者：刘燕[1] 任建军[1] 梁伟民 吕畅 冯晓贤 康荣田[1] Liu Yan;Ren Jianjun;Liang Weimin;Lyu Chang;Feng Xiaoxian;Kang Rongtian(Department of A nesthesiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Chin)

机构地区：[1]河北医科大学第二医院麻醉科,石家庄050000

出　　处：《国际麻醉学与复苏杂志》2018年第5期496-499,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：背景 颈动脉内膜剥脱术（carotid endarterectomy, CEA）已成为治疗颈动脉狭窄的主要手段。 为及时发现并逆转脑缺血，临床采用了多种技术手段优化术中监测、管理，但围手术期并发症及卒中率仍高达5%。如何预防和降低术后并发症，是麻醉管理面临难题之一。 目的 为CEA术中麻醉监测和管理提供参考。 内容 主要介绍CEA术中常用监测方法的特点及研究进展。 趋向 探索不同监测技术在CEA中的应用价值，提高患者围手术期安全性，减少围手术期并发症。Background Carotid endarterectomy（CEA） is one of the major choices for the treatment of carotid stenosis. A variety of intraoperative monitoring and management techniques were used to respectively detect and reverse cerebral ischemia. However, the incidences of perioperative complications and stroke are still as high as 5%. Appropriate anesthetic management might be of great importance to lower the incidences. Objective To review studies in anesthetic monitoring and management during CEA. Content CEA has been used to eliminate plaques deposited on the wall of carotid. To perform this surgery, both upstream and downstream parts of carotid around the plaques have to be clamped, which produces transient cerebral ischemia, usually followed by complications. To prevent the complications, perioperative monitoring techniques have been performed to fulfill real-time measurement of hemodynamic and neurophysiological parameters. The techniques include cerebral regional oxygen saturation, stump pressure, transcranial doppler, even-related potentials, jugular bulb venous oxygen saturation, and consciousness during awake, etc. This paper reviews the principles and advancements of these techniques and also their application in CEA. Trend During CEA, combinatory monitoring of multiple parameters may be necessary to obtain synthetic feedback information to improve safety and prognosis of the patients.

关 键 词：颈动脉内膜剥脱术 脑缺血 麻醉监测 围手术期处理 

分 类 号：R614[医药卫生—麻醉学]