CAJ | 학술논문

目的：分析单中心接受颈动脉内膜切除术( CEA)后患者的脑神经损伤发生率,并探讨其与手术经验的相关性。方法回顾性分析2001年1月-2013年12月于首都医科大学宣武医院接受CEA治疗的颈动脉狭窄598例患者的资料,术后7 d根据临床症状评估脑神经损伤的发生情况,并进行1、3、6、12个月的随访,评估永久性脑神经损伤的发生率。将患者进一步按2001年1月-2011年9月和2011年10月-2013年12月两个时间段分析脑神经损伤的发生率。结果(1)连续纳入行CEA治疗患者共598例,共15例(2．5%)发生脑神经损伤,包括2例(0．3%)面神经、7例(1．2%)舌下神经和6例(1．0%)迷走神经损伤,术后6个月仅1例(0．2%)未完全恢复。(2)2001年1月-2011年9月和2011年10月-2013年12月两个时间段,患者脑神经损伤分别为10例(3．2%,10/308)和5例(1．7%,5/290),差异无统计学意义(P>0．05)。结论 CEA后脑神经损伤总发生率较低,大部分患者3个月内可完全恢复。随着手术经验的增长,CEA后脑神经损伤发生率未明显改善。
목적：분석단중심접수경동맥내막절제술( CEA)후환자적뇌신경손상발생솔,병탐토기여수술경험적상관성。방법회고성분석2001년1월-2013년12월우수도의과대학선무의원접수CEA치료적경동맥협착598례환자적자료,술후7 d근거림상증상평고뇌신경손상적발생정황,병진행1、3、6、12개월적수방,평고영구성뇌신경손상적발생솔。장환자진일보안2001년1월-2011년9월화2011년10월-2013년12월량개시간단분석뇌신경손상적발생솔。결과(1)련속납입행CEA치료환자공598례,공15례(2．5%)발생뇌신경손상,포괄2례(0．3%)면신경、7례(1．2%)설하신경화6례(1．0%)미주신경손상,술후6개월부1례(0．2%)미완전회복。(2)2001년1월-2011년9월화2011년10월-2013년12월량개시간단,환자뇌신경손상분별위10례(3．2%,10/308)화5례(1．7%,5/290),차이무통계학의의(P>0．05)。결론 CEA후뇌신경손상총발생솔교저,대부분환자3개월내가완전회복。수착수술경험적증장,CEA후뇌신경손상발생솔미명현개선。
Objectives To analyze the incidence of cranial nerve injury in patients after receiving carotid endarterectomy ( CEA) in a single-center and to investigate its correlation with surgical experiences. Methods The clinical data of patients underwent CEA at Beijing Xuanwu Hospital, Capital Medical University from January. 2001 to December 2013 were analyzed retrospectively. Cranial nerve injury was assessed at day 7 after procedure according to the clinical symptoms,and they were followed up at 1,3,6, and 12 months. The incidence of permanent cranial nerve injury was evaluated. The incidences of permanent cranial nerve injury were further analyzed at two time periods ( from January 2001 to September 2011 and from October 2011 to December 2013 ) . Results ( 1 ) A total of 598 consecutive patients treated with CEA were enrolled,and 15 (2. 5%) of them had cranial nerve injury,including 2 (0. 3%) facial nerve injury,7 (1. 2%) hypoglossal nerve injury,and 6 (1. 0%) vagus nerve injury. Only 1 case (0. 2%) did not recover completely at 6 months after procedure. ( 2 ) The patients with cranial nerve injury were 10 (3. 2%,10/308) and 5 (1. 7%,5/290) respectively from January 2001 to September 2011 and from October 2011 to December 2013). There was no significant difference (P < 0. 05). Conclusion The incidence of cranial nerve injury was low after CEA,and most patients could recover completely. The increased surgical experiences did not show the reduction of cranial nerve injury rate evidently after CEA.