颅外段颈动脉瘤的外科治疗体会  

Surgical treatment of extracranial carotid artery aneurysm

作　　者：杨燎[1] 陈忠[1] 王盛[1] YANG Liao;CHEN Zhong;WANG Sheng(Department of Vascular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所血管外科,100029

出　　处：《心肺血管病杂志》2020年第11期1373-1375,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:颅外段颈动脉瘤是极其罕见的疾病,发病率为1%~1.5%,可导致卒中、短暂性脑缺血(TIA)等严重症状,国内外相关文献报道显示,目前颈动脉瘤治疗仍以外科手术为主。方法:对安贞医院血管科,2002年至2017年共收治颅外颈动脉瘤25例患者进行总结,男性17例,女性8例,年龄29~80岁,平均55.3岁,其中症状性病变21例,体检发现4例。其中2例为双侧病变,共27处病变,行26例手术,其中24例开放手术,2例腔内手术。结果:手术成功率100%,围术期无死亡,围术期并发症3例,1例发生急性脑梗死,1例假性动脉瘤复发,1例颅神经损伤。术后,中位随访时间为49个月,失访5例,随访率80%。随访期间无死亡病例,1例患者在术后36个月同侧脑梗塞,1例患者在术后90个月发现腹主动脉瘤并行腔内治疗。结论:颅外段颈动脉瘤外科治疗围术期和长期疗效良好,开放手术目前仍是主要治疗手段。Objective:Extracranial carotid artery aneurysms(ECAA)are very rare,the morbidity is about 1%-1.5%.However it can caurse many severe symptoms like stroke and transien ischemic attack(TIA).Methods:This study represents retrospective analysis of 25 patients(mean age 55.3 years old,17 men)of ECAAs witch treatment in vascular department of Anzhen Hospital.21 patients were symptomatic.There were 27 lesions of these cases,and 26 lesions were treated by surgery witch 24 were treated by open surgery and 2 were treated by endovascualr therapy.Results:Surgery successful rate were 100%.there was no mortality and 3 peri-operative complications:1 acute stroke,1 recurrent pseudoaneurysm,1 Cranial nerve injury.No death during a mean follow-up of 66 months.Postoperative complications included one stroke during 36 months.Conclusions:Extracranial carotid artery aneurysms can be treated well by surgery,and open surgery will still be the first choice of the therapy.

关 键 词：颅外段颈动脉瘤 外科治疗 

分 类 号：R54[医药卫生—心血管疾病]