国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2011年
2期
240-243
,共4页
冠心病%颈动脉狭窄%颈动脉内膜剥脱术%颈动脉支架置入术
冠心病%頸動脈狹窄%頸動脈內膜剝脫術%頸動脈支架置入術
관심병%경동맥협착%경동맥내막박탈술%경동맥지가치입술
Coronary artery disease%Carotid stenosis%Carotid endarterectomy%Carotid artery stenting
背景 冠心病(coronary artery bypass grafting,CABG)合并颈动脉狭窄者临床上并不少见.如何正确处理CABG患者并存颈动脉狭窄的问题应引起重视.目的 为了探索CABG患者并存颈动脉狭窄的最佳处理方法,此文将CABG患者并存颈动脉狭窄的外科治疗及麻醉处理进行了分析汇总.内窖对于合并颈动脉狭窄的CABG患者,最佳治疗策略尚未达成共识.既往外科治疗多采用分期或同期颈动脉内膜剥脱术(carotid endarterectomy,CEA),但近年来随着经皮介入治疗技术的发展,大多数可以采用分期或同期经皮颈动脉支架置人术(carotid artery stenting,CAS).CABG合并颈动脉狭窄患者围术期麻醉处理的关键是维持血流动力学平稳,保证大脑的有效灌注压,避免脑缺血和栓塞.趋向 同日CAS-CABG"杂交"手术已显示出可行性,并有待进一步研究.
揹景 冠心病(coronary artery bypass grafting,CABG)閤併頸動脈狹窄者臨床上併不少見.如何正確處理CABG患者併存頸動脈狹窄的問題應引起重視.目的 為瞭探索CABG患者併存頸動脈狹窄的最佳處理方法,此文將CABG患者併存頸動脈狹窄的外科治療及痳醉處理進行瞭分析彙總.內窖對于閤併頸動脈狹窄的CABG患者,最佳治療策略尚未達成共識.既往外科治療多採用分期或同期頸動脈內膜剝脫術(carotid endarterectomy,CEA),但近年來隨著經皮介入治療技術的髮展,大多數可以採用分期或同期經皮頸動脈支架置人術(carotid artery stenting,CAS).CABG閤併頸動脈狹窄患者圍術期痳醉處理的關鍵是維持血流動力學平穩,保證大腦的有效灌註壓,避免腦缺血和栓塞.趨嚮 同日CAS-CABG"雜交"手術已顯示齣可行性,併有待進一步研究.
배경 관심병(coronary artery bypass grafting,CABG)합병경동맥협착자림상상병불소견.여하정학처리CABG환자병존경동맥협착적문제응인기중시.목적 위료탐색CABG환자병존경동맥협착적최가처리방법,차문장CABG환자병존경동맥협착적외과치료급마취처리진행료분석회총.내교대우합병경동맥협착적CABG환자,최가치료책략상미체성공식.기왕외과치료다채용분기혹동기경동맥내막박탈술(carotid endarterectomy,CEA),단근년래수착경피개입치료기술적발전,대다수가이채용분기혹동기경피경동맥지가치인술(carotid artery stenting,CAS).CABG합병경동맥협착환자위술기마취처리적관건시유지혈류동역학평은,보증대뇌적유효관주압,피면뇌결혈화전새.추향 동일CAS-CABG"잡교"수술이현시출가행성,병유대진일보연구.
Background Patients undergoing coronary artery bypass grafting (CABG) concomitant with carotid stenosis are very common in clinic. How to optimally manage such patients is always worthy of attention. Purpose In order to figure out optimal methods to manage patients with carotid stenosis scheduled for CABG, this article has reviewed surgical treatments and perioperative anesthetic managements of patients undergoing CABG concomitant with carotid stenosis. Content Optimal management of patients with combined coronary and carotid artery disease remains controversial. Staged or combined carotid endarterectomy (CEA) and CABG were generally adopted in the past. Recently, with the development of percutaneous intervention techniques, many patients can undergo staged or combined carotid artery stenting (CAS) and CABG. The key point to deal with such patients is maintaining hemodynamic stabilization, to ensure sufficient perfusion to brain and avoid cerebral ischemia or embolism. Trend Same-day hybrid revascularization by carotid stenting and CABG is feasible, but still needs further research.
