CAJ | 학술논문

目的分析翻转式颈动脉内膜剥脱术及颈动脉内膜剥脱+人工血管补片成形术治疗颅外段颈动脉狭窄患者的疗效及安全性.方法回顾性分析北京协和医院血管外科2009年10月至2012年10月行颈动脉内膜剥脱术的颈动脉狭窄患者资料,分为翻转式颈动脉剥脱组(eCEA)和颈动脉剥脱+补片成形组(pCEA).结果共248例患者完成随访,共行274例次手术,其中eCEA组101例次,pCEA组173例次.所有手术操作顺利.两组患者性别、年龄、危险因素、病变狭窄程度及双侧病变例数比较,差异无统计学意义(P＞0.05).eCEA组在转流管使用率(15.8％)、抗生素使用率(26.7％)、手术时间(88±20) min、术中出血量(45±16) ml及住院天数(16±4)d上均低于pCEA组,差异有统计学意义(P＜0.05).两组并发症、手术相关死亡、术后再狭窄及术后同侧脑卒中比较,差异无统计学意义(P＞0.05).结论两种手术方式均安全有效,eCEA术式具有潜在优势,但具体术式选择需根据患者颈动脉病变情况、术者经验等进行选择.
목적 분석번전식경동맥내막박탈술급경동맥내막박탈+인공혈관보편성형술치료로외단경동맥협착환자적료효급안전성.방법 회고성분석북경협화의원혈관외과2009년10월지2012년10월행경동맥내막박탈술적경동맥협착환자자료,분위번전식경동맥박탈조(eCEA)화경동맥박탈+보편성형조(pCEA).결과 공248례환자완성수방,공행274례차수술,기중eCEA조101례차,pCEA조173례차.소유수술조작순리.량조환자성별、년령、위험인소、병변협착정도급쌍측병변례수비교,차이무통계학의의(P＞0.05).eCEA조재전류관사용솔(15.8％)、항생소사용솔(26.7％)、수술시간(88±20) min、술중출혈량(45±16) ml급주원천수(16±4)d상균저우pCEA조,차이유통계학의의(P＜0.05).량조병발증、수술상관사망、술후재협착급술후동측뇌졸중비교,차이무통계학의의(P＞0.05).결론 량충수술방식균안전유효,eCEA술식구유잠재우세,단구체술식선택수근거환자경동맥병변정황、술자경험등진행선택.
Objective To analyze the efficacy and safety of eversion carotid endarterectomy (eCEA) and carotid endarterectomy with patch angioplasty (pCEA) in the treatment of carotid artery stenosis.Methods The clinical data were collected and analyzed for the patients with carotid artery stenosis undergoing carotid endarterectomy at Department of Vascular Surgery,Peking Union Medical College Hospital from October 2009 to October 2012.According to two different surgical procedures,they were divided into 2 groups of eCEA and pCEA.Results A total of 248 patients received a follow-up.Among 274cases of endarterectomy,101 cases of eCEA and 173 cases of pCEA were performed.No significant difference (P ＞ 0.05) existed between two groups in gender,age,risk factors,stenotic degree of carotid artery or ratio of bilateral lesions.The ratio of shunt (15.8％) and antibiotics (26.7％) application,the duration of operation (88 ±20) min,intraoperative blood loss (45 ± 16) ml and the length of stay (16 ±4)days in the group eCEA were significantly lower than those of group pCEA (P ＜ 0.05).There was no significant difference (P ＞ 0.05) between two groups in the ratio of complications,surgery-related mortality,restenosis and ipsilateral stroke.Conclusion Both surgical procedures are both safe and effective in the treatment of carotid artery stenosis.However eCEA offers potential advantages.The choice of a particular surgical procedure depends on the surgeon experience and specific circumstances of carotid artery lesions.