中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
2期
129-132
,共4页
陈东%王先伟%万晓楠%姜晓辉%崔思福%石军伟
陳東%王先偉%萬曉楠%薑曉輝%崔思福%石軍偉
진동%왕선위%만효남%강효휘%최사복%석군위
双侧分期颈动脉内膜切除术%双侧颈动脉粥样硬化性狭窄%临床疗效%手术策略%间隔时间
雙側分期頸動脈內膜切除術%雙側頸動脈粥樣硬化性狹窄%臨床療效%手術策略%間隔時間
쌍측분기경동맥내막절제술%쌍측경동맥죽양경화성협착%림상료효%수술책략%간격시간
Staged bilateral carotid endarterectomy%Bilateral carotid atherosclerotic stenosis%Clinical efficacy%Surgical strategy%Time interval
目的 对双侧颈动脉重度粥样硬化性狭窄患者分期接受双侧颈动脉内膜切除术以预防和治疗缺血性脑卒中的临床疗效进行评价,浅析双侧颈动脉重度狭窄的手术策略.方法 回顾性分析2009年3月至2013年3月大连市中心医院收治的双侧颈动脉重度狭窄患者33例,狭窄程度均为70％～99％.对所有患者分期行双侧颈动脉内膜切除术,手术均采用全麻,所有病例术中均未采用转流管,其中标准式颈动脉内膜切除术(sCEA) 13例26次,外翻式颈动脉内膜切除术(eCEA) 20例40次,两期手术时间间隔为0.5 ～10个月,平均为1.5个月.结果 所有手术术中操作顺利,所有患者术后脑缺血症状明显改善,所有患者围手术期内均未出现死亡及脑卒中事件,并且在术后1～36个月的随访中均未出现脑卒中及其他严重并发症,且患者的生活质量有明显改善.结论 分期行双侧颈动脉内膜切除术对双侧颈动脉重度狭窄患者预防和治疗缺血性脑卒中是安全有效的,两期手术间隔时间与患者预后无明显相关性.
目的 對雙側頸動脈重度粥樣硬化性狹窄患者分期接受雙側頸動脈內膜切除術以預防和治療缺血性腦卒中的臨床療效進行評價,淺析雙側頸動脈重度狹窄的手術策略.方法 迴顧性分析2009年3月至2013年3月大連市中心醫院收治的雙側頸動脈重度狹窄患者33例,狹窄程度均為70％～99％.對所有患者分期行雙側頸動脈內膜切除術,手術均採用全痳,所有病例術中均未採用轉流管,其中標準式頸動脈內膜切除術(sCEA) 13例26次,外翻式頸動脈內膜切除術(eCEA) 20例40次,兩期手術時間間隔為0.5 ～10箇月,平均為1.5箇月.結果 所有手術術中操作順利,所有患者術後腦缺血癥狀明顯改善,所有患者圍手術期內均未齣現死亡及腦卒中事件,併且在術後1～36箇月的隨訪中均未齣現腦卒中及其他嚴重併髮癥,且患者的生活質量有明顯改善.結論 分期行雙側頸動脈內膜切除術對雙側頸動脈重度狹窄患者預防和治療缺血性腦卒中是安全有效的,兩期手術間隔時間與患者預後無明顯相關性.
목적 대쌍측경동맥중도죽양경화성협착환자분기접수쌍측경동맥내막절제술이예방화치료결혈성뇌졸중적림상료효진행평개,천석쌍측경동맥중도협착적수술책략.방법 회고성분석2009년3월지2013년3월대련시중심의원수치적쌍측경동맥중도협착환자33례,협착정도균위70％～99％.대소유환자분기행쌍측경동맥내막절제술,수술균채용전마,소유병례술중균미채용전류관,기중표준식경동맥내막절제술(sCEA) 13례26차,외번식경동맥내막절제술(eCEA) 20례40차,량기수술시간간격위0.5 ～10개월,평균위1.5개월.결과 소유수술술중조작순리,소유환자술후뇌결혈증상명현개선,소유환자위수술기내균미출현사망급뇌졸중사건,병차재술후1～36개월적수방중균미출현뇌졸중급기타엄중병발증,차환자적생활질량유명현개선.결론 분기행쌍측경동맥내막절제술대쌍측경동맥중도협착환자예방화치료결혈성뇌졸중시안전유효적,량기수술간격시간여환자예후무명현상관성.
Objective To evaluate the clinical efficacy and strategy of staged bilateral carotid endarterectomy(SBCEA) for patients with bilateral severe carotid atherosclerotic stenosis.Methods 33 patients with bilateral carotid atherosclerotic severe stenosis (70％-99％) were admitted to our hospital from March 2009 to March 2013.The patients all were diagnosed carotid atherosclerotic stenosis according to clinical manifestations,carotid CDFI,TCD,carotid and brain DSA/CTA/MRA.All of patients underwent staged bilateral CEA by general anesthesia without intraoperative shut,therein 13 of them by sCEA and the others by eCEA.The time interval between two stages was from 0.5 to 10 months,and the average was 1.5 months.Results The clinical manifestations were all improved after operation,and there was no mortality and stroke complications postoperatively.All of the patients were followed-up for 1-36 months after surgery,no stroke or other severe complications were found and the quality of life was improved.Conclusions It is safe and effective that patients with bilateral severe carotid atherosclerotic stenosis undergo staged bilateral carotid endarterectomy.There is no significant difference in prognosis,even though the time interval between two stages has no influence on outome.
