颈动脉狭窄合并冠心病同期外科治疗的疗效分析:单中心经验  

Analysis of the efficacy of concurrent surgical treatment for carotid artery stenosis combined with coronary heart disease:A single center experience

作　　者：叶志东[1] 贺斌 张建彬[1] 陈洁[1] 刘鹏[1] Ye Zhidong;He Bin;Zhang Jianbin;Chen Jie;Liu Peng(Department of Cardiovascular Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院心脏血管外科,北京100029

出　　处：《中国血管外科杂志（电子版）》2024年第1期28-31,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的总结同期颈动脉血运重建手术及冠状动脉血运重建手术治疗颈动脉狭窄合并冠心病患者的单中心临床经验。方法回顾性分析2008年1月至2020年1月中日友好医院心脏血管外科收治的54例颈动脉狭窄合并冠心病患者资料,其中同期行颈动脉内膜剥脱术(carotid endarterectomy,CEA)+冠状动脉搭桥术(coronary artery bypass grafting,CABG)38例,同期行颈动脉支架植入术(carotid artery stenting,CAS)+CABG 16例。结果手术成功率100%。围手术期内出现小卒中3例,短暂性脑缺血发作4例,术后短暂低血压8例,术后高灌注综合征3例,二次开胸3例,心肌梗死4例;无围手术期死亡病例。同期CEA+CABG组与同期CAS+CABG组的手术时间、术中出血量、围手术期输血量、神经系统并发症和循环系统并发症发生率差异均无统计学意义(P>0.05)。48例患者获得随访,随访时间29~140个月,平均(89.8±35.6)个月,因心肌梗死和心功能不全死亡患者各1例。结论同期CEA+CABG与同期CAS+CABG治疗颈动脉狭窄合并冠心病患者均安全有效。Objective To summarize the single-center clinical experience of simultaneous carotid artery revascularization and coronary artery revascularization surgery in the treatment of patients with carotid artery stenosis and coronary heart disease.Methods The clinical data of 54 patients with carotid artery stenosis and coronary heart disease admitted to the Department of Cardiovascular Surgery,China-Japan Friendship Hospital from January 2008 to January 2020 were analyzed retrospectively.Thirty-eight cases underwent concurrent carotid endarterectomy(CEA)combined with coronary artery bypass grafting(CABG),and 16 cases underwent concurrent carotid artery stenting(CAS)combined with CABG.Results The surgical success rate was 100%.There were 3 cases of minor stroke,4 cases of transient ischemic attack,8 cases of postoperative transient hypotension,3 cases of postoperative hyperperfusion syndrome,3 cases of secondary thoracotomy,and 4 cases of myocardial infarction in the perioperative period.No perioperative death case occurred.There were no statistically significant differences in the operation time,intraoperative blood loss,perioperative blood transfusion volume,neurological complications and circulatory system complications between concurrent CEA+CABG group and concurrent CAS+CABG group(P>0.05).48 patients were followed-up for 29 to 140 months,with an average of(89.8±35.6)months.One patient each died due to myocardial infarction and cardiac insufficiency.Conclusion Concurrent CEA+CABG and concurrent CAS+CABG are both safe and effective in the treatment of patients with carotid artery stenosis and coronary heart disease.

关 键 词：颈动脉狭窄 冠心病 颈动脉内膜剥脱术 颈动脉支架植入术 冠状动脉搭桥术 同期手术 

分 类 号：R654[医药卫生—外科学]