中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2008年
14期
1041-1044
,共4页
刘亚民%郑刚%王崇宝%秦皓%屈根学%马强%冯骏%刘唤玲%孙寒生%贺朝
劉亞民%鄭剛%王崇寶%秦皓%屈根學%馬彊%馮駿%劉喚玲%孫寒生%賀朝
류아민%정강%왕숭보%진호%굴근학%마강%풍준%류환령%손한생%하조
颈动脉狭窄%血管内支架植入%血管内膜切除术
頸動脈狹窄%血管內支架植入%血管內膜切除術
경동맥협착%혈관내지가식입%혈관내막절제술
Carotid stenosis%Endovascular stendng%Carotid endarterectomy
目的 探讨在不同条件下如何合理选择颈动脉狭窄的治疗方式.方法 回顾性分析经颈动脉血管内支架植入术(CAS)和颈动脉内膜切除术(CEA)治疗的133例颈动脉狭窄患者的临床资料.其中46例患者行CAS,87例行CEA.观察两组患者的住院天数和治疗前后的美国国立卫生研究院卒中评分量表(NIHSS)评分、前向血流,治疗前和治疗后1-24个月狭窄处收缩期血流速度峰值及狭窄程度,以及治疗后死亡、脑卒中或心肌梗死等终点事件的发生率.结果 两组住院天数和治疗后NIHSS评分>20层次时差异有统计学意义(P<0.05);两组治疗前后的前向血流评定差异无统计学意义(P>0.05);多普勒频谱测定两组治疗前后颈动脉狭窄程度有显著性差异(P<0.05);两组治疗后30 d内,终点事件的累计发生率差异有统计学意义(P<0.05);31 d~2年终点事件的累计发生率差异无统计学意义(P>0.05);6个月后再狭窄发生率CAS组高于CEA组.结论 CAS和CEA对颈动脉狭窄的效果无显著差异,狭窄的部位、原因及对侧病变是选择CAS和CEA的重要因素.
目的 探討在不同條件下如何閤理選擇頸動脈狹窄的治療方式.方法 迴顧性分析經頸動脈血管內支架植入術(CAS)和頸動脈內膜切除術(CEA)治療的133例頸動脈狹窄患者的臨床資料.其中46例患者行CAS,87例行CEA.觀察兩組患者的住院天數和治療前後的美國國立衛生研究院卒中評分量錶(NIHSS)評分、前嚮血流,治療前和治療後1-24箇月狹窄處收縮期血流速度峰值及狹窄程度,以及治療後死亡、腦卒中或心肌梗死等終點事件的髮生率.結果 兩組住院天數和治療後NIHSS評分>20層次時差異有統計學意義(P<0.05);兩組治療前後的前嚮血流評定差異無統計學意義(P>0.05);多普勒頻譜測定兩組治療前後頸動脈狹窄程度有顯著性差異(P<0.05);兩組治療後30 d內,終點事件的纍計髮生率差異有統計學意義(P<0.05);31 d~2年終點事件的纍計髮生率差異無統計學意義(P>0.05);6箇月後再狹窄髮生率CAS組高于CEA組.結論 CAS和CEA對頸動脈狹窄的效果無顯著差異,狹窄的部位、原因及對側病變是選擇CAS和CEA的重要因素.
목적 탐토재불동조건하여하합리선택경동맥협착적치료방식.방법 회고성분석경경동맥혈관내지가식입술(CAS)화경동맥내막절제술(CEA)치료적133례경동맥협착환자적림상자료.기중46례환자행CAS,87례행CEA.관찰량조환자적주원천수화치료전후적미국국립위생연구원졸중평분량표(NIHSS)평분、전향혈류,치료전화치료후1-24개월협착처수축기혈류속도봉치급협착정도,이급치료후사망、뇌졸중혹심기경사등종점사건적발생솔.결과 량조주원천수화치료후NIHSS평분>20층차시차이유통계학의의(P<0.05);량조치료전후적전향혈류평정차이무통계학의의(P>0.05);다보륵빈보측정량조치료전후경동맥협착정도유현저성차이(P<0.05);량조치료후30 d내,종점사건적루계발생솔차이유통계학의의(P<0.05);31 d~2년종점사건적루계발생솔차이무통계학의의(P>0.05);6개월후재협착발생솔CAS조고우CEA조.결론 CAS화CEA대경동맥협착적효과무현저차이,협착적부위、원인급대측병변시선택CAS화CEA적중요인소.
Objective To explore reasonable clinical decision in treating carotid artery stenosis under difierent conditions.Methods The data of 133 carotid artery stenosis patients were retrospectively analyzed.Of the patients.46 cases were treated with carotid angioplasty and stenting(CAS),87 patients received carotid endarterectomy(CEA).The length of hospital stay and National Institutes of Health Stroke Scale(NIHSS)grade before and after treatment in both groups were observed;the forward flow were assessed by digital subtraction angiography(DSA)before and after treatment;the degree of carotid artery stenosis were determined by using ultrasound during 3 to 24 months after treatment in both groups;the cumulative incidence of major cardiovascular events was concentrated,including appearance of death,stroke or myocardial infarction during 30 days after CAS and CEA and death or homonymy stroke during 31 days to 2 years.Results Significant difierence was found in hospital stay and when NIHSS exceed 20 after treatment between the two groups(P<0.05);there was no significant difference in the forward flow beforeand after treatment in both groups:the carotid artery stenosis had been improved significantly after the operation in both groups;the cumulative incidence of major eardiovascular events in CEA group was significandy higher than in CAS group in 30 days after the operation(P<0.05),but no statistical difference in 31 days to 2 years after the operation.Conclusions CAS and CEA has equivalent effects in treating carotid artery stenosis,and should be selected according to the location of stenosis,etiological factors and the condition of opposite carotid artery.