CAJ | 학술논문

目的探讨颈动脉内膜剥脱术围手术期并发症的预防和治疗.方法收集2000年10月至2013年1月本院共进行颈动脉内膜剥脱术318例患者的临床资料并进行回顾性分析.结果术前因造影引起脑梗死3例,致长期偏瘫2例,失语1例；术中低血压16例,用0.5％利多卡因行颈动脉窦局部封闭恢复正常；高灌注综合征18例,用甘露醇和速尿脱水治疗3～5 d好转；术后发生大面积脑梗死1例,经抗凝和扩血管治疗好转,但长期偏瘫失语；声嘶14例,均在1周后痊愈；颈部血肿28例,6例进行了手术清除,其他行局部引流；术后死亡3例,其中突发心肌梗死2例,肺部感染1例.结论颈动脉内膜剥脱术围手期并发症重点在预防,仔细的术前准备、谨慎的术中操作及术后观察均能明显降低并发症的发生.
목적 탐토경동맥내막박탈술위수술기병발증적예방화치료.방법 수집2000년10월지2013년1월본원공진행경동맥내막박탈술318례환자적림상자료병진행회고성분석.결과 술전인조영인기뇌경사3례,치장기편탄2례,실어1례；술중저혈압16례,용0.5％리다잡인행경동맥두국부봉폐회복정상；고관주종합정18례,용감로순화속뇨탈수치료3～5 d호전；술후발생대면적뇌경사1례,경항응화확혈관치료호전,단장기편탄실어；성시14례,균재1주후전유；경부혈종28례,6례진행료수술청제,기타행국부인류；술후사망3례,기중돌발심기경사2례,폐부감염1례.결론 경동맥내막박탈술위수기병발증중점재예방,자세적술전준비、근신적술중조작급술후관찰균능명현강저병발증적발생.
Objective To introduce the experience of prophylaxis and management of the complications of carotid endarterectomy (CEA) during perioperative period because those complications can not be avoided yet.Methods During Oct 2000 to Jan 2013,318 patients were performed CEA.There were 213 men and 105 women with an average age of 74.8 years ranged from 48 to 85y.There were 186 patients in the left,120 patients in the right,and 12 patients in two sides.Simply,CEA are performed in 166 patients,CEA and patch in 140,and 12 patients were performed bypass with the autogenously great saphenous vein after the lesions removal.Results The perioperative complications were preoperative stroke in 3 cases,hypotension during operation in 16,after-operation deaths in 3,hyperperfusion syndrome in 18,postoperative severe cerebral infarction in 1,hoarseness in 14,and hematoma in 28.Conclusions Perioperative complications of CEA can be decreased by cautious surgical procedure and postoperative observation.