CAJ | 학술논문

目的：比较颈动脉内膜剥脱术(CEA)及颈动脉支架置入术(CAS)治疗颈动脉狭窄1年内效果。方法收集2011年6月~2013年6月于蚌埠医学院第一附属医院收治的CEA(CEA组，16例)和CAS(CAS组，10例)26例颈动脉狭窄患者的临床资料，分析两种术式的治疗效果及1年出现的脑部、心血管及局部并发症，重度再狭窄(狭窄率>70%)的情况。结果 CEA组患者经治疗后显效12例(75.0%)，有效3例(18.8%)，无效1例(6.2%)；CAS组患者经治疗后显效7例(70.0%)，有效2例(20.0%)，无效1例(10.0%)。CEA组有4例(25.0%)发生局部并发症，1例(6.3%)发生心肌梗死，CAS组有2例(20.0%)发生局部并发症，1例(10.0%)发生脑卒中，两组均无病死病例。两组1年内血管再狭窄的发生例数分别为0例(0.0豫)及3例(30.0%)。两组患者术后在显效、有效、无效、总有效的治疗指标比较，差异均无统计学意义(P>0.05)。两组患者局部并发症、脑卒中、心肌梗死及病死发生率比较，差异无统计学意义(P>0.05)。1年内CAS组颈动脉血管再狭窄发生率明显高于CEA组，差异有统计学意义(P<0.05)；1年内两组患者总并发症发生率比较，差异无统计学意义(P>0.05)。结论对于颈动脉粥样硬化性狭窄的患者，CEA是首选的治疗方式。
목적：비교경동맥내막박탈술(CEA)급경동맥지가치입술(CAS)치료경동맥협착1년내효과。방법수집2011년6월~2013년6월우방부의학원제일부속의원수치적CEA(CEA조，16례)화CAS(CAS조，10례)26례경동맥협착환자적림상자료，분석량충술식적치료효과급1년출현적뇌부、심혈관급국부병발증，중도재협착(협착솔>70%)적정황。결과 CEA조환자경치료후현효12례(75.0%)，유효3례(18.8%)，무효1례(6.2%)；CAS조환자경치료후현효7례(70.0%)，유효2례(20.0%)，무효1례(10.0%)。CEA조유4례(25.0%)발생국부병발증，1례(6.3%)발생심기경사，CAS조유2례(20.0%)발생국부병발증，1례(10.0%)발생뇌졸중，량조균무병사병례。량조1년내혈관재협착적발생례수분별위0례(0.0예)급3례(30.0%)。량조환자술후재현효、유효、무효、총유효적치료지표비교，차이균무통계학의의(P>0.05)。량조환자국부병발증、뇌졸중、심기경사급병사발생솔비교，차이무통계학의의(P>0.05)。1년내CAS조경동맥혈관재협착발생솔명현고우CEA조，차이유통계학의의(P<0.05)；1년내량조환자총병발증발생솔비교，차이무통계학의의(P>0.05)。결론대우경동맥죽양경화성협착적환자，CEA시수선적치료방식。
Objective To compare the treatment effect of carotid stenosis with carotid endarterectomy (CEA) and carotid artery stenting (CAS) in 1 year. Methods From June 2011 to June 2013, in the First Affiliated Hospital of Bengbu Medical College, the data of 26 patients with carotid artery stenosis were selected and divided into two groups, according to operation method, CEA group (16 cases) and CAS group (10 cases). The complications caused by two surg-eries include cardiovascular, cerebrovascular, local complications and severe restenosis (stenosis rates>70%) were an-alyzed. Results After the treatment, in CEA group, markedly effect were 12 cases (75.0%), general effect were 3 cases (18.8%) and no effect was 1 case (6.2%); in CAS group, markedly effect were 7 cases (70.0%), general effect were 2 cases (20.0%) and no effect was 1 case (10.0%). In CEA group, local complications were 4 cases (25.0%), myocardial infarction was 1 case (6.3%); in CAS group, local complications were 2 cases (20.0%), stroke was 1 case (10.0%), no death occurred. The incidences of restenosis in 1 year of two groups were 0 case (0.0%) and 3 cases (30.0%). The over-all treatment effects of two groups was compared, the differences were not statistically significant (P>0.05). The patients' local complications, stroke, myocardial infarction, and death rates of two groups were compared, the differences were not statistically significant (P> 0.05). The carotid restenosis in 1 year CAS group was significantly higher than the CEA group, the difference was statistically significant (P< 0.05). The complications were not statistically significant (P>0.05). Conclusion For carotid stenosis, CEA is the preferred treatment.