标准式颈动脉内膜斑块切除术与外翻式颈动脉内膜斑块切除术治疗颈动脉狭窄临床研究  

The clinical study of standard carotid endarterectomy and eversion carotid endarterectomy for carotid artery stenosis

作　　者：杨雅鸽 李震[1] 秦晶[1] 付蕾[1] 朱亮 化召辉[1] YANG Ya-ge;LI Zhen;QIN Jing;FU Lei;ZHU Liang;HUA Zhao-hui(Department of Endovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院腔内血管外科,郑州450000

出　　处：《医药论坛杂志》2024年第19期2095-2098,共4页Journal of Medical Forum

基　　金：河南省重点研发与推广专项(科技发展计划)项目(232102311033)。

摘　　要：目的研究标准式颈动脉内膜斑块切除术(standard carotid endarterectomy,sCEA)与外翻式颈动脉内膜斑块切除术(eversion carotid endarterectomy,eCEA)治疗颈动脉狭窄的效果。方法回顾性分析郑州大学第一附属医院2022年1月至2023年12月108例行颈动脉内膜斑块切除术(carotid endarterectomy,CEA)患者临床资料,根据手术方式不同分为对照组(sCEA)和研究组(eCEA),每组54例,比较两组疗效。结果研究组总有效率(94.44%)与对照组(92.59%)相比,差异无统计学意义(P>0.05);术前两组认知功能分值比较,差异无统计学意义(P>0.05);术后3个月组内比较,两组认知功能均改善,差异有统计学意义(P<0.05);术后3个月组间比较,两组认知功能差异无统计学意义(P>0.05);研究组阻断、手术时间为(21.46±2.18)min及(80.14±15.45)min,均短于对照组,抗生素、转流管使用率及治疗费用均低于对照组(P<0.05);研究组神经损伤、脑卒中等并发症发生率3.70%、1.85%,与对照组7.41%、3.70%相比,差异无统计学意义(P>0.05),但研究组术后再狭窄率1.85%,低于对照组的5.56%,差异有统计学意义(P<0.05)。结论sCEA、eCEA均可有效治疗颈动脉狭窄,且安全性较高,eCEA在减少阻断、手术时间,转流管使用率及治疗费用等方面更具优势,能够降低术后再狭窄发生率,可作为治疗颈动脉狭窄的首选方式。Objective To investigate the efficacy of standard carotid endarterectomy(sCEA)and valvulation carotid endarterectomy(eCEA)in the treatment of carotid artery stenosis.Methods The clinical data of 108 patients undergoing carotid endarterectomy(CEA)from January 2022 to December 2023 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed,and they were divided into control group(sCEA)and study group(eCEA)according to different surgical methods,with 54 cases in each group.Results The total effective rate of the study group was 94.44%compared with 92.59%in the control group,with no statistical significance(P>0.05).The cognitive function scores before surgery of the two groups were no ststictical significance(P>0.05).Three months after operation,the cognitive function of both groups was improved(P<0.05).Three months after operation,the difference of cognitive function scores between the two groups were no ststictical significance(P>0.05).The duration of blockade and operation in the study group was(21.46±2.18)min and(80.14±15.45)min,both shorter than that in the control group,and the utilization rate of antibiotics,circulation tube and treatment cost were lower than those in the control group(P<0.05).The incidence of neurological injury,stroke and other complications in the study group was 3.70%and 1.85%,which had no statistical significance compared with 7.41%and 3.70%in the control group(P>0.05).However,the postoperative restenosis rate in the study group was 1.85%,which was lower than 5.56%in the control group(P<0.05).Conclusion Both sCEA and eCEA can effectively treat carotid artery stenosis with high safety.eCEA has more advantages in reducing blockade,operation time,antibiotics,circulation tube utilization rate and treatment cost,can reduce the incidence of postoperative restenosis,and can be used as the first choice for the treatment of carotid artery stenosis.

关 键 词：颈动脉狭窄 颈动脉内膜斑块切除术 临床研究 

分 类 号：R543[医药卫生—心血管疾病]