颈动脉内膜剥脱术后急性颈内动脉闭塞临床特征分析  

Clinical characteristics of acute internal carotid artery occlusion after carotid endarterectomy

作　　者：闻忠诚 李嘉楠 宋伟龙 张海峰 于春泳 潘鹏宇 梁国标 曲颖 WEN Zhong-cheng;LI Jia-nan;SONG Wei-long;ZHANG Hai-feng;YU Chun-yong;PAN Peng-yu;LIANG Guo-biao;QU Ying(Dalian Medical University Graduate School,Dalian 116000,China;Department of Neurosurgery;Department of Casualty Management,General Hospital of Northern Theater Command,Shenyang l10016,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116000 [2]北部战区总医院神经外科,辽宁沈阳110016 [3]北部战区总医院伤病员管理科,辽宁沈阳110016

出　　处：《临床军医杂志》2024年第10期1000-1003,1009,共5页Clinical Journal of Medical Officers

基　　金：辽宁省兴辽英才计划(XLYC2002109)。

摘　　要：目的分析颈动脉内膜剥脱术(CEA)后发生急性颈内动脉闭塞患者的临床特征。方法回顾性分析北部战区总医院自2017年1月至2022年12月收治的行CEA的1564例患者的临床资料。其中,5例在术后出现了急性颈内动脉闭塞。收集5例患者的临床和影像学资料,以及治疗信息。结果5例(0.32%,5/1564)患者在术后24 h内复查头颈部CT血管成像发现急性颈内动脉闭塞,急诊行颈内动脉开通术。5例患者均为颈内动脉起始部重度狭窄(狭窄程度>90%),同侧颅内段存在夹层,Willis环代偿良好,CEA后即刻可见良好的颈内动脉返血,术后无新发神经功能缺损。结论CEA后发生急性颈内动脉闭塞具有一定的形态学共性,术后颈内动脉返血良好不能预测并发症的发生可能。Objective To analyze the clinical features of patients with acute internal carotid artery occlusion after carotid endarterectomy(CEA).Methods The clinical data of 1564 patients with CEA from January 2017 to December 2022 in General Hospital of Northern Theater Command were retrospectively analyzed.Among them,5 patients developed acute internal carotid artery occlusion after surgery.Clinical and imaging data and treatment information of 5 patients were collected.Results In 5 cases(0.32%,5/1564),acute internal carotid artery occlusion was found by CT angiography of head and neck within 24 h after operation,and internal carotid artery opening was performed in emergency.All the 5 patients had severe initial stenosis of internal carotid artery(stenosis degree>90%),dissection in the ipilateral intracranial segment,good compensation of the circle of Willis,good internal carotid artery return immediately after CEA,and no new nerve function defect after surgery.Conclusion Acute internal carotid artery occlusion after CEA has certain morphological commonality,and good internal carotid artery return can not predict the possibility of complications.

关 键 词：颈动脉内膜剥脱术 颈内动脉闭塞 颈内动脉狭窄 串联病变 

分 类 号：R651.1[医药卫生—外科学]