CAJ | 학술논문

目的：总结颈动脉内膜剥脱术对防治缺血性脑卒中的经验。方法对196例患者进行颈动脉内膜剥脱术，均为单侧。术中应用颈动脉转流管47例，阻断血流149例。术前均经颈动脉造影检查，选择颈内动脉狭窄＞70％者133例，＞95％者63例。71例患者并存冠状动脉病变，17例同台行冠状动脉搭桥。结果术后临床症状改善满意191例，术后1周内出现脑出血3例，经开颅止血引流，痊愈1例，死亡2例。出现颈部切口内血肿12例，再手术清创止血获愈。随访6～60个月，获得随访166例，失访28例，死于其他疾病或灾祸38例，无脑缺血症状再发作128例。结论颈动脉内膜剥脱术是治疗颈动脉重度狭窄的一种有效、安全术式。
목적：총결경동맥내막박탈술대방치결혈성뇌졸중적경험。방법대196례환자진행경동맥내막박탈술，균위단측。술중응용경동맥전류관47례，조단혈류149례。술전균경경동맥조영검사，선택경내동맥협착＞70％자133례，＞95％자63례。71례환자병존관상동맥병변，17례동태행관상동맥탑교。결과술후림상증상개선만의191례，술후1주내출현뇌출혈3례，경개로지혈인류，전유1례，사망2례。출현경부절구내혈종12례，재수술청창지혈획유。수방6～60개월，획득수방166례，실방28례，사우기타질병혹재화38례，무뇌결혈증상재발작128례。결론경동맥내막박탈술시치료경동맥중도협착적일충유효、안전술식。
Objective To summarize the experience of carotid endarterectomy in prevention and treatment of the ischemic stroke .Methods From October 2001 to December 2011 , 196 patients with unilateral internal carotid artery stenosis received carotid endarterectomy .In operation, carotid artery, shunts were applied in 47 cases, bloc-king blood flow in 149 cases.The preoperative carotid angiography showed internal carotid artery stenosis greater than 70%in 133 cases, more than 95%in 63 cases.There were 71 cases to be complicated by coronary artery lesions , 17 cases received coronary artery bypass simultaneously .Results The postoperative clinical symptoms improved in 191 cases, cerebral hemorrhage appeared in 3 cases within 1 week after operation, among them after the hemostatic crani-otomy drainage , 1 case was healed , 2 cases died .In 12 cases hematoma appealed inside cervical incision and were cured by the surgical debridement hemostasis .All cases were followed up for 6 to 60 months, 166 cases received fol-low-up, lost fellow-up in 28 cases, 38 cases died of disaster or ill in a follow-up.There were no attack of cerebral is-chemic symptoms again in128 cases.Conclusion Carotid endarterectomy is an effective and safe treatment for severe carotid artery stenosis .