CAJ | 학술논문

目的：探讨对椎动脉狭窄和闭塞进行手术治疗的经验。方法本组28例，男21例，女7例；年龄52～73（68.3±0.03）岁；病程3个月至4年。左侧15例，右侧13例。依据椎动脉开口所在的位置不同，采用了两种术式。全身麻醉下16例患者采用了内膜剥脱术，10例行椎动脉与锁骨下动脉自体大隐静脉搭桥术，2例行椎动脉与颈总动脉端侧吻合术。结果1例于术后1周吻合口出血而再次手术，所有患者术后症状消失，痊愈出院；长期随访，3例在6个月后发生闭塞。6个月总通.率89.28％（25/28），其中内膜切除术为87.5％（14/16），椎动脉-锁骨下动脉搭桥术为90％（9/10）。结论开放手术治疗椎动脉狭窄和闭塞症疗效显著，操作简单。选择的术式必须依据椎动脉起始位置和锁骨下动脉解剖情况而定。
목적：탐토대추동맥협착화폐새진행수술치료적경험。방법본조28례，남21례，녀7례；년령52～73（68.3±0.03）세；병정3개월지4년。좌측15례，우측13례。의거추동맥개구소재적위치불동，채용료량충술식。전신마취하16례환자채용료내막박탈술，10례행추동맥여쇄골하동맥자체대은정맥탑교술，2례행추동맥여경총동맥단측문합술。결과1례우술후1주문합구출혈이재차수술，소유환자술후증상소실，전유출원；장기수방，3례재6개월후발생폐새。6개월총통.솔89.28％（25/28），기중내막절제술위87.5％（14/16），추동맥-쇄골하동맥탑교술위90％（9/10）。결론개방수술치료추동맥협착화폐새증료효현저，조작간단。선택적술식필수의거추동맥기시위치화쇄골하동맥해부정황이정。
Objective To explore surgical experience of stenoses or occlusion of the vertebral artery .Methods In this group, there were 28 patients including 21 men and 7 females with average of 52 ~73 (68.3 ±0.03) y, duration 3 months to 4 years , and 15 lesions in the left and 13 lesions in the right .All patients were performed operation under general anesthesia .There were 16 vertebral artery endarterectomy , 10 subclavian-vertebral bypass and 2 end-side anastomosis between vertebral artery and common ca-rotid artery.Results One patient had to be performed second operation at the 7th day after endarterectomy because of anastomotic bleeding.All patients were cured.The patency rate of 6 months was 89.28%(25/28) in all patients.Conclusions Surgical man-agement of stenoses or occlusion of the vertebral artery has excellent curative effect with simply operation .However , the technique must be selected according to anatomic circumstances of vertebral artery and subclavian artery .